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.
Summary
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of the Messengers, Muhammad, and upon all his family and companions.
The circle of taboos in the Jewish Sharia is wider than other laws, as the Jews have severe and very complicated rituals in the matter of food, which may not be found among other people of other religions, as the dietary laws that specify foods and drinks forbidden in the Jewish Sharia include very diverse topics. The Torah specified all these laws with several texts
God saw his servants with truth and light, and made him easy for them, and he commanded those who help them, including a counselor, guide and preacher, so if a Muslim sees deficiencies or defects, he must help him to reform and refine it. That it was in the hands of the prophets, God Almighty created the human being together straight, then melted on those scholars and researchers in all religions on psychological counseling and religious sychotherapy, stressing the importance of religious values in the process of understanding man in the process of psychotherapy and in controlling human behavior. A lot of research and studies have been published. I dealt with the religious approach in the process of treating mental disorders and the aim of
... Show MoreThe study showed that Imam Said bin Jubair narrated in the transcriber and copied, which took most of the ink of the nation Ibn Abbas (may Allah be pleased with them), which amounted to fourteen novels.
The study also pointed out that the science of transcriber and copied is from the science of the Koran, which can only prove by the novel and the correct transmission of the Prophet Muhammad .
The study also showed that Imam Saeed bin Jubair, who says that it is permissible to copy in the Koran, contrary to what some scholars said that it is not permissible to copy.
The study also pointed to the possibility of copying and that the highest copies of the Koran Koran.
The results of the historical review of social and political realities in general show that the practical and procedural applications of social engineering as a particular activity primarily of the social and political characteristics of man and society emerged in modern Western societies before appearing in other societies, These results also show that the emergence of these practical reasons and their applications in the West has also seen the emergence of modern theoretical foundations there, which seems to be the usual and usual context everywhere and in most or not all areas of life. Since the social and political dimensions are intertwined in human life and are in full, comprehensive and lasting harmony, interest in this geometry h
... Show MoreThe reaction paths of the C-C and C-H bond cleavage in the anthracene and phenanthrene aromatic molecules are studied by applying the ab-initio DFT method. It is found that the C-C bond cleavage proceeds via a singlet aromatic transition state, compelled through a disrotatoric ring opening reaction. A suprafacial H atom shift follows the transition state, leading to the formation of a methylene -CH2 and an acetylenic or allenic moiety. The calculated activation energies for anthracene range from 158.81-208.90 kcal/mol and the reaction energies from 96.106-156.976 kcal/mol. For phenanthrene, the energy values are 157.39-202.34 kcal/mol and 62.639-182.423 kcal/mol, respectively. For the C-H cleavage reactions, the calculated reaction energies
... Show MoreIn this research, the covariance estimates were used to estimate the population mean in the stratified random sampling and combined regression estimates. were compared by employing the robust variance-covariance matrices estimates with combined regression estimates by employing the traditional variance-covariance matrices estimates when estimating the regression parameter, through the two efficiency criteria (RE) and mean squared error (MSE). We found that robust estimates significantly improved the quality of combined regression estimates by reducing the effect of outliers using robust covariance and covariance matrices estimates (MCD, MVE) when estimating the regression parameter. In addition, the results of the simulation study proved
... Show MoreA simplified parallel key was presented in this work for the Taxa of Stackys L. wildly grown in Iraq. Three records within this genus were newly recorded to our country in the present work and they are S. kermanshahansis Rech S. setifera C.A. Mey. subsp setifera, S. setifera ssp iranica (Reck.) The characteristics of these new records were also given with some representative specimens.
The research aims to design an electronic program that allows users to assess the possibility of different practices for projects management professional according to the PMBOK methodology)) and using the requirements Data mentioned in the "knowledge and experience in project management Evaluation guide" issued by the professional Institute of project management According to the results of this program will be electronic The possible classification of project management in terms of both (proficiency_ perform tasks) as less than the desired level or within or above average in terms of best practices, and finally a number of recommendations to overcome the possible shortcomings. The most important is the need to enrich the service
... Show MoreBackground: The main purpose of this study is to find if there is any correlation between the level of C-reactive protein (CRP) in gingival crevicular fluid with its serum level in chronic periodontitis patients and to explore the differences between them according to the probing depth. Materials and methods: Forty seven male subjects enrolled in this study. Thirty males with chronic periodontitis considered as study group whom further subdivided according to probing depth into subgroup 1 with pocket depth ≤6mm, subgroup 2 with pocket depth >6mm. The other 17 subjects considered as controls. For all subjects, clinical examination where done for periodontal parameters plaque index (PLI), gingival index (GI), bleeding on probing (BOP),
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