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.
Schools and artistic trends derive their themes from artistic styles and styles as methods followed by the artist to express his themes embodied in the values of artistic and plastic elements as symbols and signs that can be described according to the type of art school and the extent to which the artist is influenced in employing them as a goal to achieve the plastic achievement in the painting, and from those vocabulary (human beings nature Life) as encoded messages that have an appearance and an interior, the appearance of which are forms, colors, formats and distributions of space and their interior meanings and semantics embody attitudes, events and circumstances that stem from the social depth and daily life and derive their comp
... Show MoreThe research deals with the relationship between supplier evaluation (single variable) and family brand strategy (single variable) a case study in the battery factory\Al-Waziriya, and the fact that the industrial sector represents a cornerstone for building the country’s economy of and their development. The research has been selected on this basis. The problem stems from the lack of business understanding of the real role played by the assessment of the suppliers' and its strong impact on its reputation and position in the market. The research gains its importance by moving away from traditional marketing style in terms of characteristics related to the resource itself, and the service provided by the factory to c
... Show MoreRhythm is considered one of the creative concepts in the recent architectural thought; it has emerged clearly as a mean of creating the highest levels of creativity in architecture, especially in contemporary architectural movements. The importance of rhythm has emerged, especially, when the architecture , its beginnings concentrated on the principle of the links with poetic structures. Many architectural studies deal with concept of rhythm in architecture with different ways various according to the trend of each study, this show the importance of studying the concept of rhythm in the architectural field in general. This study try to focus on the utilization of rhythm as creative system in architecture of heritage and contemporary
... Show MoreRheumatoid arthritis is a chronic, progressive, inflammatory autoimmune disease of unidentified etiology, associated with articular, extra-articular and systemic manifestation that require long-standing treatment. Taking patient’s beliefs about the prescribed medication in consideration had been shown to be an essential factor that affects adherence of the patient in whom having positive beliefs is an essential for better adherence. The purpose of the current study was to measure beliefs about medicines among a sample of Iraqi patients with Rheumatoid arthritis and to determine possible association between this belief and some patient-certain factors. This study is a cross-sectional study carried out on 250 already diagnosed rheumatoid
... Show MoreOne of the issues that occupied the doctrinal mind and differed the attention of scientists is the question of (the quality of the composition of God), so each team of scientists went the doctrine that led him to his evidence.
I wanted through this research to stand on the truth of the matter according to what I reached after looking at the views of the people and their evidence and direct the dispute between scientists.
It was presented with an introduction that was an introduction to the issue, where it began with the introduction of the definition of attributes, and then began to define the composition and view the views of scientists and evidence, and then concluded it with a conclusion mentioning what I have reached.
The metallicity [Fe/H] for several stars accompanied by Extra-solar planets were calculated and plotted as a function of stars mass (M*). Results showed that masses of Extra-solar planets stars are well correlated with their metallicity .This relation could be explained by the equation: Y=-0.0045x + 0.065. The metallicity limit is found to be in the range of (0.18 to 0.3), relative to the mass limit in the range of (0.76 to 1.44) MSun.
This criteria is a good tool that can be used by observers who are aiming for detecting Extra-solar planets
The research aims to identify the level of balance in the architectural thought influenced by the rational type human consciousness, the materialistic based on the Empirical type, moral based on human experience as source of knowledge.
This was reflected in architecture in the specialized thought that the mind is the source of knowledge which explains the phenomena of life. The rational approach based on objectivity and methodology in (Form Production), the other approach is based on subjectivity in form production (Form Inspiration).
The research problem is that there is imbalance in the relationship between the rational side and the human experience in architecture, which led into imbalance between theo
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