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.
مقدمة
تدور الدراسة في علم الاقتصاد المنزلي حول احتیاجات الانسان الضروریة لاستمرار الحیاة ومواقف في محیط
الاسرة وتفاعل مع ظروف البیئة المحیطة بھ .والتي تكون دائمة التغییر لذلك یمكن تعریف علوم وفنون الاقتصاد
المنزلي وفنونھ انھا عبارة عن مجموعة منظمة من المعارف والعلوم تتركز في محور الاسرة والمنزل حیث ینمو
ویتطور الانسان بالعلاقات الانسانیة والنواحي الاقتصادیة والاجتماعیة من جھة والنواحي العلمیة وا
The substantial key to initiate an explicit statistical formula for a physically specified continua is to consider a derivative expression, in order to identify the definitive configuration of the continua itself. Moreover, this statistical formula is to reflect the whole distribution of the formula of which the considered continua is the most likely to be dependent. However, a somewhat mathematically and physically tedious path to arrive at the required statistical formula is needed. The procedure in the present research is to establish, modify, and implement an optimized amalgamation between Airy stress function for elastically-deformed media and the multi-canonical joint probability density functions for multivariate distribution complet
... Show MoreStudied competence spam to malicious moth figs at temperatures and Kagafat host different results showed that female intruder, despite their ability to shell larvae host and when densities of different, but it is able to lay eggs at a temperature of 14 + or -1 and finally urged the efficiency spam to malicious affected heavily host and that the greater the intensity of the host spam increased efficiency and its performance life
Abstract
The study was conducted in Baghdad and aimed to:
The impact of moving the educational activities in the conservation of literary
texts and the development of literary taste in the fifth grade students moral "by
verifying the validity of hypotheses Elsafreeten following forms:
The first hypothesis:
- There are no differences in women with statistical significance between means
of scores of students three experimental groups, the experimental group first
used upstream activities in the teaching material of literature and texts, the
second experimental group used the activities of building in the teaching
material itself and the experimental group the third use activities concluding
taught the same
This research deals with one scene from the movie Romeo and Juliet, which is the balcony scene, due to the importance of this scene in the formation of the construction of the subsequent events of the movie.
The first chapter contained the methodological framework of the research, where the research problem was identified in how Zeffirelli dealt with the balcony scene in the play Romeo and Juliet and enriched it in the cinematic language with a comparison with the original text of the scene. In the balcony scene with comparative parts between the film and the text and the limits of the research that was limited to the film Zeffirelli and the translated text by Munis Taha Hussein.
The second chapter contained the theoretic
... Show MoreBackground: Coping skills play a vital role in managing the physical and psychological effects of breast cancer (BC). Despite improvements in early detection and treatment, Breast cancer survivors continue to face long-term challenges after diagnosis. Therefore, this study aims to evaluate the coping skills employed by breast cancer women in Iraq and to identify the sociodemographic, clinical, and psychological factors associated with these coping skills. Methods: A cross-sectional study was conducted among 244 breast cancer women in The Medical City Teaching Oncology Hospital, Baghdad, Iraq, from August 2023 to October 2023, coping skills and psychological factors were assessed using the BRIEF COPE-28, and Hospital Anxiety Depression scale
... Show MoreThe research aims to achieve a set of the most important objectives of the review of the role of creative administrative leadership in achieving aspects of economic reform in various government institutions and indicate the role of supervisory awareness of administrative leadership in the revitalization of the role of the internal control system to achieve the best use of available resources. This paper deals with three problems is the loss of financial resources of the state as a result of the growing phenomenon of administrative and financial corruption in the majority of government institutions, and the weakness of the role of the internal control system in the province on the resources available and to achieve the best use of these reso
... Show MoreAbstract:
Saudi Arabia and United States long relation could present an important
subject to understand alliance kind in international relations types. We trying
in this study to diagnose and analyze the Saudi Arabia and United States
model to find balance and unbalance statues and its influence on the
directions of Saudi Arabia foreign policy positions.
We divided the study in two parts, each part have many sections. The
first part deal with the historian emergence of Saudi Arabia state and its
development in three stages including its foreign relations with regions and
international powers. While the second part was dedicated in analyzing and
understanding the mechanism and active facts that drawing the Sa