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.
The research aims to find out the relationship between the medical and nursing staffing and its impact on the quality of provided health service in the Yarmouk Teaching Hospital, and to understand the nature of the relationship between doctors and nurses, it has been the adoption of cooperation and conflict Kmngaran independent knowledge of the relationship between doctors and nurses and the quality of health service as a variable certified by eating five dimensions (tangibility, reliability, safety, responsiveness, empathy). The research was adopted to collect data on the questionnaire prepared medical and nursing to the angel and adopted included Likert Quintet her, and distributed to doctors working in the Yarmouk hospital in
... Show MoreBackground: Dysfunction of sinoatrial node is a set of abnormal rhythms which are resulted from the sinoatrial node malfunctionof the sinus node, the chief natural cardiac pacemaker. The common, and occasionally, the single method for treatment of heart arrhythmias wasimplantation of pacemaker, which reduce symptoms exactly occurs after implantation. Aim: To detect the association between red cell width diameter (RDW) and some cardiac electrophysiology parameters in sinus node dysfunction in Iraqi patients such as SNRT and AH. Methods: A cross sectional study, was conducted on 59 patient ranging between 20-50 years old and involving 35 female and 24 male patients, suffering from an unexplained symptoms of sinoatrial node dysfunction (SND).
... Show MoreThe phenomenon of spatial variation in the economic, social and urban development levels is considered prevalent in most of the economic and social systems,this relates to the concentration of most of those activities in certain regions and because of their rarity in other regions , that led to the emergence of the problem of the sharp contrast between the most developed areas and least developed areas within the same region or within the regions of the same country,
Reduction of this variables , in addition to the development of areas through following up and relying on an effective regional development enabling to reduce unemployment as well as to stop the migration of the unplanned for population,
And the ideal use of available
Material obtained from the demolition of concrete structures and milling of flexible pavements has the highest potential for recyclability. This study aimed to evaluate the performance of hot mix asphalt with the concurrent use of recycled asphalt pavement (RAP) and recycled concrete aggregate (RCA). Contents of RAP and RCA were varied from 0% to 50% by fixing the total recycling materials percentage to 50%. Penetration grade 40/50 virgin binder and waste engine oil (WEO) as rejuvenator were used in the present study. A series of tests, such as Scanning electron microscopy (SEM), Marshall stability, indirect tensile strength test, IDEAL CT, uniaxial compression test, and resilient modulus test, were carried out to assess the performance of
... Show MoreThe present paper attempts to establish a distinction between Exochomus negripennis (Er.) and E. quadripustulatus L., depending on the characters of femoral line, male genitalia and spermatheca.
Abstract
The current research is attempt to test the reflection of the lean management on the human resources management practices of two of the most important communication companies operating in Iraq (`Zain & Asia cell), The research aims to Determine the extent of adoption of the lean management approach in the two researched companies, as it improving human resource management practices. The research problem represented in the existence of lack of in some aspects of the application the lean management approach in service sector and neglecting the impact of its tools on the human resource management practices. For this purpose three principle research hypotheses has been formulated, first there is a correlation rel
... Show MoreThe digital revolution had greatly affected the methods through which we communicate, starting from the basic concepts of the internet technology and the web content in addition to the important issues that concern the culture of the digital media, the internet governance and the variation in the digital age in general and the graphic and internal design in particular.
This research addresses an important topic that goes along with the scientific development in the field of the digital design, especially in the internal and graphic designs. This study consists of two sections: the first includes the problem of the study and the need for it. Starting from the problem of the research, there is no clear perception of the formal characte
Addressed this research the impact of intelligence emotional dimensions of the main(self awareness, and self-management, and social awareness, and relationship management) in the performance excellence the university(performance optimization, and strategic development) this is by middling the styles decision making which are (rational and intuitive, and dependent, and spontaneous, and avoidant), and Go search of an intellectual dilemma raise fundamental questions revolve around the search was to answer those questions through a theoretical framework for search variables first and test models of the relationship and second through the impact six hypotheses President.The objective of the research to make sure the contr
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