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The Combination Effect of Lidocaine, Ketamine and Atracurium in Intravenous Regional Anesthesia
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Background: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intravenous regional anaesthesia.Methods: In prospective, randomized study, sixty patient ASA physical status I, aged 20-50years underwent surgeries on distal regions of upper limbs, patient assigned randomly into 3 groups each of 20 patients, group I received 30ml of 0.5% lidocaine (150mg), group II received 30ml of mixing 0.5% of lidocaine (100mg) plus 30mg ketamine, while group III received 30ml of mixing 0.5% lidocaine (100mg) plus 30mg ketamine plus 2mg atracurium. All the results were tabulated and analyzed statistically with student's unpaired t-test and chi-square test. Results: Addition of 30mg of ketamine to 0.5% lidocaine resulted in rapid onset of sensory block, motor block, and lower visual analogue scale scores for pain compared with the group that received lidocaine only. The addition of atracurium to the combination of lidocaine and ketamine resulted in improved operating conditions and rapid onset of both sensory and motor blocks with less pain during surgery.Conclusions: drug combination of ketamine, atracurium and low dose of lidocaine lead to rapid onset of sensory block, motor block, lower VAS score for pain, and decrease adverse effect of Bier’s block accompany lidocaine alone, decrease drowsiness which accompany ketamine use alone in IVRA

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Publication Date
Thu Jan 29 2026
Journal Name
Journal Of Interdisciplinary Mathematics
Efficient design of neural network based on modified LM training algorithm for solving nonlinear 4th order 3D-PDEs 
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Authors in this work design efficient neural networks, which are based on the modified Levenberg - Marquardt (LM) training algorithms to solve non-linear fourth - order three -dimensional partial differential equations in the two kinds in the periodic and in the non-periodic - Periodic. Software reliability growth models are essential tools for monitoring and evaluating the evolution of software reliability. Software defect detection events that occur during testing and operation are often treated as counting processes in many current models. However, when working with large software systems, the error detection process should be viewed as a random process with a continuous state space, since the number of faults found during testin

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Publication Date
Mon Jul 01 2013
Journal Name
Political Sciences Journal
Towards Promoting Political Participation of Female - University Students - Field Study on Al-Quds Open University Female - Students - Rafah
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نحو تعزيز المشاركة السياسية للطالبات الجامعيات الفلسطينيات

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Publication Date
Sun Oct 15 2017
Journal Name
Research Journal Of Applied Sciences, Engineering And Technology
Optimization of IPv6 Protocol Independent Multicast-Sparse Mode Multicast Routing Protocol based on Greedy Rendezvous Point Selection Algorithm
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Publication Date
Sun Oct 01 2023
Journal Name
Rawal Medical Journal
Fixation of unstable intertrochanteric fractures with proximal femoral nailing: Supine position with traction table versus lateral decubitus position
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Objective: To compare two positioning approaches in the surgical treatment of unstable intertrochanteric femoral fractures fixed by proximal femoral nailing, the supine versus lateral decubitus position Methodology: This randomized prospective comparative study on 26 patients with unstable intertrochanteric fractures was carried out from January 2020 and June 2022. We randomly divided patients into two groups: group A (13 patients) were operated using the traction table in the supine position for implant insertion, and group B (13 patients) were operated using the lateral decubitus position. We compared both groups regarding the setup time, operative time, tip-to-apex distance, collodiaphyseal angle, time for fluoroscopic time expo

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Publication Date
Fri Sep 01 2023
Journal Name
Journal Of Building Engineering
Discharge performance assessment of a vertical double-pipe latent heat storage unit equipped with circular Y-shaped fins
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This paper aims to study the effect of circular Y-shaped fin arrangement to improve the low thermal response rates of a double-tube heat exchanger containing Paraffin phase change material (PCM). ANSYS software is employed to perform the computational fluid dynamic (CFD) simulations of the heat exchanger, including fluid flow, heat transfer, and the phase change process. The optimum state of the fin configuration is derived through sensitivity analysis by evaluating the geometrical parameters of the Y-shaped fin. For the same height of the fins (10 mm), the solidification time is reduced by almost 22%, and the discharging rate is enhanced by almost 26% using Y-shaped fins compared with the straight fins. The results demonstrate that the sol

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Publication Date
Wed Oct 04 2023
Journal Name
Environmental Progress & Sustainable Energy
Removal of <scp>E133</scp> brilliant blue dye from artificial wastewater by electrocoagulation using cans waste as electrodes
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Abstract<p>Solid‐waste management, particularly of aluminum (Al), is a challenge that is being confronted around the world. Therefore, it is valuable to explore methods that can minimize the exploitation of natural assets, such as recycling. In this study, using hazardous Al waste as the main electrodes in the electrocoagulation (EC) process for dye removal from wastewater was discussed. The EC process is considered to be one of the most efficient, promising, and cost‐effective ways of handling various toxic effluents. The effect of current density (10, 20, and 30 mA/cm<sup>2</sup>), electrolyte concentration (1 and 2 g/L), and initial concentration of Brilliant Blue dye (15 and 30 mg/L) on </p> ... Show More
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Publication Date
Fri Feb 25 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Prospective Comparative Study of Fixing Displaced Transverse Patellar Fracture by Tension Band Wiring Versus Cannulated Screws with Wiring
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BACKGROUND: Transverse fractures of the patella are important fractures with a wide variety of subtypes, the common incidence in the age group of 20–50 years. Surgical interference aims to achieve a perfect alignment of the joint surface, in addition to rigid fixation of the fracture for early re-habitation and early movement to retain the extensor mechanism of the knee joint. AIM: The aim of this study was to compare the radiological and functional outcomes of the displaced transverse patella fracture in adult patients treated by ORIF using tension band wiring versus cannulated screws with wiring. METHODS: A prospective analytic comparative study was conducted in Al-Kindy Teaching Hospital/Baghdad/Iraq for 18 months from Apr

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Publication Date
Fri Dec 31 2021
Journal Name
Iraqi Journal Of Laser
Parametric Optimization for Fatigue Life of 6061-T6 Aluminum Thin Sheets Processed with High-Speed Laser Shock Peening
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Abstract: Aluminum alloys grade 6061-T6 are characterized by their excellent properties and processing characteristics which make them ideal for varieties of industrial applications under cyclic loading, aluminum alloys show less fatigue life than steel alloys of similar strength. In the current study, a nanosecond fiber laser of maximum pulse energy up to 9.9 mJ was used to apply laser shock peening process (LSP) on aluminum thin sheets to introduce residual stresses in order to enhance fatigue life under cyclic loading Box-Behnken design (BBD) based on the design of experiments (DOE) was employed in this study for experimental design data analysis, model building and optimization The effect of working parameters spot size (ω), scannin

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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Photochemistry And Photobiology A: Chemistry
Silver oxide-zeolite for removal of an emerging contaminant by simultaneous adsorption-photocatalytic degradation under simulated sunlight irradiation
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Publication Date
Tue May 02 2023
Journal Name
Social Science Journal
An Investigation of Microstructure Analysis for World Health Organizatioan Speeches during Covid-19 Pandemic: Adopted Van Dijk Theory
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