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
Abstract
The logistic regression model is one of the nonlinear models that aims at obtaining highly efficient capabilities, It also the researcher an idea of the effect of the explanatory variable on the binary response variable. &nb
... Show MoreThe subject of improving the performance of services provided by government institutions of the important topics at the present time because of their direct contact at the service of citizens and the increased importance of these units as a result of the diversity of activities performed by the so governments of the countries and their people made sure to pay attention to the good use of those allocated to those sectors of resources and spending in the service prescribed and manage the highest level of efficiency and effectiveness and monitor the proper management of the money used in those sectors and evaluate their performance through the Supreme Audit Institutions so that they can play their role oversight and contribute to th
... Show MoreTo achieve excellence in the quality of performance in school sports administration, which has suffered a lot of problems and constraints on the administrative system, supervision and education level as well as the regulatory environment and available resources available and contribute to the provision of some processors and overcome difficulties to participate in the formation of the individual good of itself and society through sports activities. Hence the importance came this study to create a reference to the quality of the performance criteria school sports from the perspective of supervisors (specialists and technicians) in the districts of breeding Baghdad, to be of help to all those involved in school sports and maintaining an excep
... Show MoreThe aim of the present study is to provide the adequate knowledge about the role of time management in facilitate the work requirements for employees of the administrative department at the Ministry of Higher Education and Scientific Research. The research depend on studying four important dimensions which are (time planning, time organization, time direction and time observation). In addition to study other five dimensions which are (new procedures, clear procedures, short procedures, the available information and the simplicity of the methods
used).Questionnaire sheets consist of (38 questions) distributed to (170) employees and (146) sheets only were considered in the study. SPSS program was used
... Show MoreThe research aims to know the impact of science, technology, engineering, and mathematics education on both creative thinking and mathematical achievement. To achieve it, the two researchers followed the quasi-experimental approach with an experimental design for two groups, one experimental and the other a control. The research sample consisted of (32) female students from the fourth scientific grade in Al-Intisar Preparatory School for Girls/ AlRasafa, First Directorate. The sample was chosen intentionally and was divided into two groups: a control group studying by the traditional method, their number (16), and an experimental group that applied the STEM approach, their number also (16). There was parity between the two research groups i
... Show MoreThe collected premiums and the compensations paid are among the main variables that have a prominent role in determining the level of financial solvency of insurance companies, as the higher the financial solvency of the insurance company, the more attractive it is to the target audience to acquire the company's insurance services.
Hence the importance of the issue of the solvency of insurance companies, as it is one of the critical matters on which the effectiveness of the insurance company and its continuation in the labor market depend.
In this research, we try to clarify the role of collected premiums and compensations paid in determining the level of operational solvency of t
... Show MoreThe stratigraphic sequence of Cenomanian-Early Turonian is composed of Ahmadi, Rumaila, and Mishrif formations in the Rifai, Noor and Halfaya Oil Fields within the Mesopotamian Zone of Iraq, which is bounded at top and bottom by unconformity surfaces. The microfacies analysis of the study wells assisted the recognition of five main environments (open marine, basinal, shallow open marine, Rudist biostrome, and lagoon); these microfacies were indicative of a normal lateral change facies from shallow water facies to deeper water and open marine sediments.
Ahmadi Formation (Early Cenomanian) is characterized by open marine sediments during the transgressive conditions, and would be
... Show MoreThe present paper aims at finding out the Variance Ratio of Trips Set Out by Scholars of Both Marrouzzeen and Baihaq .The researcher has come up with conclusion including certain findings ,one of which is that the trip is considered an essential base with high effectiveness since the old times and has been evolved .This means that the trip has been the main source of knowledge and sciences from the scholars directly .This had driven the scholars of both Baihaq and Marrouz cities .It has been noticed , though this paper, that the number of the Marrouz scholars who visited was less than those of Baihaq . The researcher has focused on their meetings or conferences and investigated what has been going on in suc
... Show MoreThis study deals with a prominent critical term - poetics - in critical studies as an area related to uncovering the laws of creative and aesthetic discourses (Preaching)، and the various functions that accompany it in literary texts. So، the study employs the pioneers' works of this theory specially the eastern theorists in making a parallel comparing study of the text book of " the Magic and Poetry” by Al-Lisan Al-Din bin Al-Khatib (776 AH). It displays the utility of the concept of poetics in the referred book pointing to the illumination of various functions that، in turn، reflected the