Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA
Thsst researcher problem of delays faced by researchers are all waiting to evaluate their standards by the experts who must take their views to extract the truth Virtual important step first step in building standards whatsoever, then the difference of opinion among experts about the paragraphs Whatever the scope of their functions, leading to confusion in maintaining these paragraphs or delete? Or ignore the views and opinion of the researcher to maintain the same? Or as agreed upon with the supervisor if he was a student? Especially if the concepts of a modern new building.
Therefore, the researcher sought to try to find a solution to her problem to conduct an experiment to test building steps
Abstract
The study aims to identify the levels of core competencies dimensions and types of organizational flexibility in the investigated organization, as well as to determine the nature of the relationship and the impact of core competencies dimensions with the process of organizational flexibility. Thus, a number of research questions were presented to express the research problem as follows:
- What is the level of the investigated individuals' awareness to core competencies and organizational flexibility across their dimensions and types in the investigated organization?
- To what extent are core competencies and organizational flexibility available in the Organiz
The present paper is devoted to studying the imitation of some Quran phrases and words in the tale of "The Leprous Girl". The paper aims at identifying the common ground between the tale and some great stories related in the verses of the holy Quran, and comparing the original work with the present translation. First, we translated the tale from Russian into Arabic so as to be tackled in study, and then an identification of the commonalities between this tale and the Quran wording is made. It was found that texting is clear in the original text of the tale, hence the need for this paper. By studying the texts and phrases employed by the writer, we observe that the text is influenced by the Quranic stories whose effects have been reflecte
... Show MoreUrban Balance is one of the important indicators that leads to an assessment of the urbanization process in a particular country , province or even a city that is multi-centered. By examining the data related to Anba province, it was found that the value of this indicator is equal to 0.96, which is less than the absolute one, and therefore the urbanization in the province is distributed collectively
The development of a mathematical or statistical model for estimating urban growth is a complex process due to the overlap between indicators or variables that can be adopted to calculate estimate growth rates Al-Qaim city has been considered as an example to develop a statistical method by which changes
... Show MoreThe research aims to measure the relationship and impact of the operations of the knowledge of management of the six dimensions (diagnosis knowledge, define knowledge objectives, knowledge generation, knowledge storage, distribution of knowledge, application of knowledge) in the fiscal performance of the General Authority for taxes of the four dimensions (financial, customers (taxpayers), Operations Interior, learn and grow), the research aims also to the use of computerized programs for training and career development of the Authority that helps to add knowledge workers in the Authority, and to reach an appropriate arrangement for knowledge management processes in the Authority, as well as analysis of the reality of the Authority to get
... Show MoreThe military presence in the Gulf region after the British withdrawal from it in 1971 was one of the most important pillars of the American strategy to climb the ladder of global leadership, as the geostrategic features that the region enjoyed provided factors of controlling energy sources and global trade routes. The United States of America guarantees Western Europe and Japan the process of access to energy sources and the exclusion of its opponents from the region, especially the Soviet Union, and the growing American military presence in the Gulf after the invasion of Iraq in 2003. On the other hand, the region experiences many contradictions, some of which threaten its security, such as the exacerbation of disputes between its count
... Show MoreThe problem of job burnout has become one of the main problems for researchers in social welfare organizations (social protection bodies) - one of the formations of the Ministry of Labor and Social Affairs. Its negative effects increased in light of the COVID-19 pandemic, and in light of the Corona pandemic, the pressures and burdens of workers varied, which resulted in high rates of anxiety, tension, and intellectual and physical exhaustion, and then negatively affected their efficiency in performing work at the individual and organizational level, especially after the increasing tasks of these Bodies in carrying out their role in achieving the general goals and objectives as beingThe general goals are that they are responsible for providi
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