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 contractual imbalance is perceived today by the majority of the doctrine as being one of the pitfalls to the execution of the contracts. As a result, most legislations grant judges the power to intervene to restore it. Granting the judge the power to complete the contract raises the question of the extent to which the judge can obtain such power. Is it an absolute authority that is not limited? If so, is it a broad discretion in which the judge operates in his conscience, or is it a power of limited scope by specific legal texts and conventions? This is what we will try to answer in this research.
Urban planning task and the control of constructional planning and urban management for cities considers the main tasks that the government takes care off. The paper discusses the concept of power from historical view of ancient Islamic cities to discover the strategies of urban management that the Islamic city adopt and to employ it in contemporary cities ,the more problems that modern cities suffer from which appears through poorness of urban context ,belongs to the loss of balance exists between the different faces of power that takes the tasks of urban management .therefore enhancement of urban environment is being through re-back that balance in administrative structures that make the cities go ahead . So the attention has b
... Show MoreThis research aims at making a comparative survey between the dry season in (2017-2018) and the wet season (2018-2019) in Iraq concerning the variation of rainfall and pressure systems responsible for such a difference. In this paper, seven climatological stations have been selected: Mosul, Kirkuk, Khanaqin, Baghdad, Rutba, Diwaniyah and Basra. Results have shown that the first category of rainfall of the two seasons has recorded a higher number of rainy days in comparison with the second and third categories with a total of 274 day in a dry season and 403 day of a wet season. Further, the total amount of the annual continuous rain is higher than the total of thunderstorms in a dry season as well as in the
... Show MoreBreastfeeding (BF) serves as a complete nutritional source for the first six months of infant’s life. Breast milk contains all essential nutrients that necessary for the physiological growth and development of infants. The aim of this study was to compare the physiological growth of infants including weight, height and head circumference who were exclusively breastfed for 6 months and those who were given bottle-fed or mixed fed and to find a percentage of exclusive breastfeeding among mothers who contributed in this study in Sulaimani city. This study was carried out in Sulaimani city/ Kurdistan region of Iraq and the cases were enrolled between the first of October 2018 and first of October 2019. The infants’ weight, height and hea
... Show MoreThe current study aimed to identify the difficulties faced by the student in mathematics and possible proposals to address these difficulties. The study used a descriptive method also used the questionnaire to collect data and information were applied to a sample of (163) male and female teachers. The results of the study found that the degree of difficulties in learning mathematics for the fifth and sixth grades is high for some paragraphs and intermediate for other paragraphs, included the student's field. The results also revealed that there were no statistically significant differences at the level of significance (α = 0.05) between the responses of the members of the study sample from male and female teachers to the degree of diffi
... Show MoreThe demand for expatriate labor to Iraq increased after 2003 as a result of the openness that Iraq experienced, but this expatriate labor, which was requested at an increasing rate, has had economic, social, and political effects on the Iraqi economy in general, and the Iraqi labor market in particular. This is due to the high rates of unemployment, as most of these expatriate workers cause competition to local labor, and thus cause repercussions on the Iraqi economy as a whole, except for those expatriate workers coming with companies working in the oil sector. Iraq's GDP
The topic of the research tagged (narrative structure and its impact on building open and closed endings in the fictional film) is summarized by studying the mechanism of employing closed and open endings in the fictional film. novelist, then the need for it, as well as the objectives of the research and clarifying its limits as well as its importance. Then moving to the theoretical framework, which included three topics, where the first topic was entitled (the cinematic construction of the film narrative), either the second topic (the structure of complexity and narrative solutions), or the third topic dealt with the subject (the structure of the end and its relationship to the construction of the narrative). After completing the theore
... Show MoreThe research problem lies in determining the beauty ranges between the receiver and the industrial product, The goal of the research, it is the definition of aesthetics in industrial design and its relation to the receiver, and the researcher outcome several conclusions of the, the most important was: 1. The role of accumulated experience, and their interaction with the vision of the artwork in achieving aesthetic perception and levels of artistic and aesthetic values and by the level of growth this taste of the recipient. 2. There are interactive and close relationship be the primary means for the integration of functional and aesthetic meaning the designer meant to get it to the receiver.