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 consists of five chapters and aims to explore the administrative skills of leaders in physical education colleges and their relationship with administrative reform. The study sample included (deans, vice deans, and heads of departments) from physical education colleges for the academic year 2012-2013, with a total of 61 individuals. They were selected using the purposive sampling method, and the researcher distributed questionnaires to them, collecting 60 valid responses and excluding one due to its invalidity. After defining the concepts of administrative skills and administrative reform and redownloading relevant literature and previous studies, as well as consulting with a group of experts in management and psychology, the r
... Show MoreThose interested in the educational process and lesson management sought to invest the information experience with industrial intelligence and technology because of its importance in increasing the effectiveness of lesson management and developing the creative capabilities of the teacher in directing and managing his lesson. Field research for sports educational institutions that are interested in managing the lesson and preparing mathematical teaching cadres is an important issue and necessary means for identifying the most important phenomena that accompany the process of managing the educational process, as the teacher's success in providing the appropriate conditions to provide rich and influencing experiences in managing and directing
... Show MoreThe study of triples seeks to deal with the comprehensive nature of the Qur’an texts, and the choice fell on the trilogy of great torment, pain, and humiliation in the Noble Qur’an - an objective study, the title of this research, in which I tried to shed light on these terms, and the nuances between them, and in particular torment The eschatological terminology varied, which can be summed up in three terms, namely the great, the painful, and the offensive. The types of torment, the pain is the painful one that is described by the severity of pain and its horror, as for the humiliating punishment, it is that which humiliates the one who has fallen on it, and the diversity of torment is due to the diversity of sins.
Abstract
The image of the soldier, as a hero who sacrifices everything to defend his
country and values, is no longer depicted in modern drama. With two World Wars
and many regional wars and civil wars, the soldier becomes a victim, not a hero.
Authors present the character of the soldier as a man who suffers a lot as he is
victimized by his own government and its politics that forces him to be in such a
position. Dramatists express their views about race, oppression and war through
their characters, such as the character of the soldier, as in the two selected plays for
this research: The Hostage by Brendan Behan and A Soldier's Play by Charles
Fuller.
The Hostage depicts, through its events, the Irish oppre
The effective application of the method of measuring and evaluating performance according to the Balanced Scorecard the need for an information system a comprehensive and integrated for internal and external environment, Which requires the need to develop accounting information system in general and cost management information systems to suit the particular requirements of the environment in terms of the development of modern methods of measurement to include the use of some methods that have proven effective in measuring and evaluating performance.
The research problem in need of management to develop methods of measuring and evaluating performance through the use of both financial measures and non
... Show MoreObjective: to evaluate the increase in weight after biological agents and the association of weight gain with the body mass index among a sample of patients attending Baghdad Teaching Hospital Methods: A prospective study is carried out in Baghdad teaching hospital biological units and outpatient clinic of rheumatology for a period of one year starting On April 2015 and ending on March 2016. 120 patients were included in the study 40 psoriatic arthritis .40 ankylosing spondylitis and 40 rheumatoid arthritis Results : The study findings indicate that significance differences are seen regarding weight gain and b