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 human perception of science and knowledge is affected by the personal point of view, thus giving it its religious, mental and emotional dimensions to make that perception an effective tool for realizing the truth comprehensively in the delivery of knowledge to the depths of the human soul. The later is composed of multiple factors, which contributes to the human self-development with dimensions beyond the limits of mental logic and the perception of material and emotional situations. That knowledge in the perception of Islamic virtue, which must characterize each Muslim.
Human beings have been striving for knowledge and the understanding of the universe in which they live. For centuries, mankind has acquired knowledge directly an
الاحداث السياسية في العراق بعد 2003 وأثر الانتماء والوعي في التشكيل العراقي المعاصر
the reality of small and medium enterprises analysis reflects weaknesses plaguing these enterprises and strengths that are characterized by, and thus the formulation of appropriate solutions to the obstacles faced by these enterprises to enhance its contribution to the achievement of economic and social development. Iraqi small and medium enterprises suffer from several obstacles stand in front of development and support their competitiveness, the finance one of the main obstacles which impede growth and development of these enterprises, noting the banking system in Iraq reluctance to lend to small and medium-sized enterprises, as a result of the high cost of lending these enterprises compared to large projects, as well as
... Show MoreNowadays, the use of recycled waste construction materials instead of aggregates is becoming popular in construction owing to its environmental benefits. This paper presents an experimental and analytical campaign to study the behavior of axially loaded columns constructed from recycled aggregates. The latter was used instead of natural aggregates, and they were collected from the waste of previous concrete constructions. Different concrete mixtures made from varying amounts of recycled aggregates ranged from 0 to 50% of the total coarse aggregate were conducted to achieve 28 MPa. The effect of steel fibers is another investigated variable with volumes ranged from 0 to 2% concerning concrete’s mixture. The experimental
... Show MoreFor Spanish learners who are not immersed in everyday contexts, such as students of Spanish as a foreign language, interaction with native speakers is an enriching experience that allows them to contrast their knowledge in a meaningful way. For its part, understanding the cognitive and grammatical functions of the so-called verbs of change plays an essential role in the development of everyday conversation,including the management of aspects such as dialectal variations.In relation to this important function, the central theme of our proposal is verbs of change. The latter have been the research base of several linguists who highlight, amidst their complex functioning in Spanish, positive communicative bases. By observing these perspecti
... Show MoreBackground: Breast cancer is the most common malignancy affecting the Iraqi population and the leading cause of cancer related mortality among Iraqi women. It has been well documented that prognosis of patients depends largely upon the hormone receptor contents and HER-2 over expression of their neoplasm. Recent studies suggest that Triple Positive (TP) tumors, bearing the three markers, tend to exhibit a relatively favorable clinical behavior in which overtreatment is not recommended. Aim: To document the different frequencies of ER/PR/HER2 breast cancer molecular subtypes focusing on the Triple Positive pattern; correlating those with the corresponding clinico-pathological characteristics among a sample of Iraqi patients diagnosed with th
... Show MoreGeography of industry has been considered a branch of important economic geographical branches. This importance has been regarded as a reflection on the industrial sector contribution in economies of any state since they contribute into the total national product ; it also assimilates a huge number of labor hands . The industry of grains grinding has been considered as one of the main food industries having a main role in satisfying the need of the population from the foods. The industry is continued to use the food as daily meal . Here, it should predict the population in Baghdad and for every district until the end of 2025 and knowing either these grains grinders are able to meet and satisfy the needs of populations of flours, making s
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