Objective : Sciatic nerve block (popliteal approach) and femoral N block is a new technique other than general anesthesia in below knee surgery because it provides adequate muscle relaxation, with good intraoperative and post-operative analgesia. Nefopam is non opioid, non-respiratory depressant and non-sedative was mixed with local anesthetics drug to study the effects. This study was done to compare the onset and duration of sensory and onset time and duration of action of motor block following administration of either bupivacaine alone with administration of bupivacaine and Nefopam in patients undergoing below knee lower limb surgeries under ultrasound guided regional anesthesia.
Methods: 100 patients with American society of anesthesiologists (ASA) 2 / 3/4 patients between 25 and 85 years who underwent elective and emergency lower limb surgeries randomly allocated into two group, each group has 50 patients by a sealed envelope technique to receive 20 ml of 0.5% Bupivacaine with 2 ml of normal saline in Group BS and 20 ml of 0.5% Bupivacaine with 2ml (20mg) of Nefopam in the second group (Group BN). The onset time, duration time of both sensory and motor blocking were seen and compared between the two groups.
Results : The onset time of both sensory and motor blockade was shorter in Group BN (bupivacaine with nefopam) when compared to Group BS (bupivacaine and normal saline) (p<0.0001). The duration of both sensory and motor blockade was longer in Group BN when compared to Group BS (p<0.0001). There were no significant hemodynamic changes (PR, BP,SPO2) in both groups. Also there is no any side effect or any complication.
Conclusion Nefopam when mixed with Bupivacaine in Sciatic nerve block and femoral nerve block in below knee surgeries shortens the onset time and prolongs the duration of action of both sensory and motor blockade without any systemic side effects and give excellent intra and postoperative analgesia.
This search seeks to know the trends of academics in the field of Press and audio, video and read press about paper press compared with continued development and widespread deployment of web journalism. This research belongs to descriptive studies which depends on sample survey approach adopted by five-meter design measuring trends. It contains 28 items having applied honesty and reliability transaction and the scale form is distributed to the sample studied of about 110 professors and then the researcher collects them and then applying the appropriate statistical program to get the results. This search seeks to know the trends of academics in the field of Press and audio, video and read press about paper press compared with continu
... Show MoreTo maintain a sustained competitive position in the contemporary environment of knowledge economy, organizations as an open social systems must have an ability to learn and know how to adapt to rapid changes in a proper fashion so that organizational objectives will be achieved efficiently and effectively. A multilevel approach is adopted proposing that organizational learning suffers from the lack of interest about the strategic competitive performance of the organization. This remains implicit almost in all models of organizational learning and there is little focus on how learning organizations achieve sustainable competitive advantage . A dynamic model that captures t
... Show MoreBeing the meeting points of the world different languages and out of a scholarly perspective, comparative literature represents a cultural leap as well as an artistic and intellectual development or a global literary movement of both prose and poetry. Such homogenous literary structure requires a systematic and coherent study of the literary output of the people different cultures and civilizations. It also represents the theoretical approach of the present study that debates a systematic comparison between Ghassan Kanafani’s All That's Left to You and William Faulkner’s. The Sound and the Fury. Within the perspective of the descriptive analysis approach, the present paper discusses th
... Show MoreGreek theatre and roman theatre don’t let for woman with working in the theatre such as writer , directing and acting theatre , so appear term women theatre in past sixty central because the woman feeling with iniquitousness in your life , so this search included several sections that include money parts . Part one is term theatre women. Part two causes show the women theatre. Part three jenouse women in writer, direction, and action in the world. Part four jenouse women in the Arab theatre. Part fife Iraqi woman jenouse in the theatre. Section tow includes analyses for once performance Iraqi theatre that include several women. This performance from editor and direction by kaseem – Muhammad, assistant in the direction montaha – rah
... Show MoreThe issue of liquidity, profitability, and money employment, and capital fullness is one of the most important issues that gained high consideration by other authors and researchers in their attempts to find out the real relationship and how can balance be achieved, which is the main goal of each deposits.
For the sake of comprising the study variables, the research has formed the problem of the study which refers to the bank capability to enlarge profits without dissipation in liquidity of the bank which will negatively reflect on the bank's fame as well as the customers' trust. For all these matters, the researcher has proposed a set of aims, the important of which is the estimation of the bank profitability; liquid
... Show MoreThe Target costing is an important modern techniques strategic managerial accounting.which is been shown active adoption to changes in contemporary business environments Inaddition,they had been adopted by the units as aresult of the growth in the strategic approach in the man agement..the goal of using target costing is to build and strengthen competitive abilities of economic units thvough introducing appropriate ways to decrease cost and improving quality of product The hypothesis reflects interest in achieving the goal of the research,ie.research question,The hypothesis use target costing to assist economic units to decrease cost and in the manner that leads to competitive advantages while surviving and flourishing in current busines
... Show MoreRheumatoid arthritis (RA) is a chronic inflammatory disease associated with decreased antioxidant state .This study aim to investigate the status of oxidant/antioxidant in a sample of Iraqi patients with RA and the role of peroxynitrite and its natural scavenger uric acid in them .This case-controlled study was conducted at Baghdad teaching hospital /Baghdad from December 2010-May 2011 . Twenty-five patients with mean age 39 years and 25 apparently healthy subject as controls with mean age 29 years were included in the study .Investigations include estimation of serum levels of nitric oxide (NO) ,peroxynitrite (PN) , malondialdehyde (MDA) , and uric acid (UA) .Serum PN levels were significantly elevated in RA patients a
... Show MoreThis present study demonstrated that liver was involved in 14 %of typhoid patients manifesting with hepatomegaly. Elevation of serum enzymes in typhoid fever was presumably of a muscular origin, while elevation of liver enzyme was relatively less common. This study was performed on 30 female patients diagnosed by ultrasound (US) of abdomen, with paratyphoid A, ranged between (20-40) years compared with 30 healthy control .Patients volunteers were treated with appropriate antibiotics for 14 days and investigations were repeated 2-3 week after completion of treatment. Patients had clinical and biochemical evidence of hepatic dysfunction. The spectrum of hepatic involvement included hepatomegaly , jaundice, derangement of various hepatic func
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