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.
Break in the bond and its impact on the difference of scholars
The Logic of Freezers and Animals in the Holy Quran
The world is witnessing a remarkable development in the use of technology, which has made it an essential means of investment, especially in the field of management, which provided many of the facilities experienced by the institutions, including improving revenues, shortening time and saving labor. Islamic investment technology as a successful means of management and we touched on the Zakat Foundation as an application model.
Abstract
The aim of the research is to clarify the requirements of the qualification of the external auditor in Iraq and the extent of their impact on the quality of the professional performance of the audit process. The research was based on analyzing the results of the questionnaire prepared for the impact of qualifications on the quality of professional performance. The researcher has reached a number of conclusions, the most important of which is that a highly qualified and unethical auditor has a greater negative impact on the quality of professional performance than those with low qualifications. The most important recommendations of the research were the need to pay
... Show MoreThe present study aims to test a range of hypotheses about the effectiveness of each of the theory of transactional leadership, and the theory of transformational leadership in the Egyptian environment, and to identify any of them are better able to predict the effectiveness of leadership. And after the effect will be to identify the quality of the relationship between the leader and the subordinate in leadership , and what is the role of transformational leadership dimensions influencing the effectiveness of leadership. The field study was conducted on a sample of companies' public and private sector and the government in Egypt. The results of the study resulted in experimental that transacti
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Abstract
Islam has been concerned with preserving and maintaining rights, so the provisions in which it is preserved are legislated. Among that is the testimony that made it a way to prove the truth and obliges its bearer to fulfill right in order to preserve the right and establish justice and prevent injustices by defying conflict, and tyranny .
And while acknowledging that divine absolute wisdom that is the cause and origin of legal rulings is sufficient, it is obligatory to abide by its provisions and imposes obedience, surrender, contentment and work in accordance with its controls.
However, the realization of the defects behind the legislation in a comprehensive way that realizes the dev
... Show MoreThis research shed light on the relationship between the social orientation of the marketing (interests of the Organization ,the welfare of society, satisfaction the customer) strategies competitive dimensions of (cost leadership strategy, differentiation strategy, focus and strategy), As well as to to seek to achieve a number of knowledge and applied goals, and represented the field research problem extent of interesting researched the application of social orientation and interest in achieving competitive strategy and omission of this interest in the hotels the surveyed Organization, Based on this problem, and to clarify the relationshi
... Show MoreLas diferencias entre el pretérito perfecto simple y el imperfecto son uno de los temas más complejos de la lengua española, no sólo para el estudiante, sino para el profesor, puesto que sistematizar los casos y hacerlos fácilmente comprensibles al alumno es tarea difícil. Los profesores de lengua, cuyas investigaciones han dado lugar a una serie de teorías y de corrientes metodológicas y didácticas que permiten enfocar la enseñanza de una lengua extranjera de manera muy distinta a como se hacía tradicionalmente. Vamos a repasar muy brevemente cuáles son estas teorías.
En primer lugar es necesario señalar en qué consiste el aprendizaje de una segunda lengua:
"El aprendizaje de una segunda lengua (L2) es el
... Show MoreDried imported blood worms Chironomus reparius was used to motivate the growth of young carp Cyprinus carpio L ., as fish powder was partial and total replaced by blood worms which is a component of the fodder of the common carp fish. Results have shown that blood worm partial replacement treatment surpasses the imported fish powder. Rates of growth motivation of this treatment have been higher than both the control and total replacement processes. Results have shown significant differences in the weight of the fish in the partial replacement of the fish powder by the blood worms.