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
The pure and Sb doped GeSe thin films have been prepared by thermal flash evaporation technique. Both the structural and optical measurement were carried out for as deposited and annealed films at different annealing temperatures.XRD spectra revealed that the all films have one significant broad amorphous peak except for pure GeSe thin film which annealed at 573 K, it has sharp peak belong to orthorhombic structure nearly at 2θ=33o . The results of the optical studies showed that the optical transition is direct and indirect allowed. The energy gap in general increased with increasing annealing temperature and decreased with increase the ratio of Sb dopant. The optical parameters such as refractive index, extinction coefficient and r
... Show MoreCdSe alloy has been prepared successfully from its high purity elements. Thin films of this alloy with different thicknesses (300,700)nm have been grown on glass substrates at room temperature under very low pressure (10-5)Torr with rate of deposition (1.7)nm/sec by thermal evaporation technique, after that these thin films have been heat treated under low pressure (10-2)Torr at (473,673)K for one hour. X-ray patterns showed that both CdSe alloy and thin films are polycrystalline and have the hexagonal structure with preferential orientation in the [100] and [002] direction respectively. The optical measurements indicated that CdSe thin films have allowed direct optical energy band gap, and it increases from (1.77- 1.84) eV and from
... Show MoreThis research focused on clarifying the relationship strategic decisions for operations management & performance excellence organizational, The research emerges from a problem which explained by many application questions. Special questionnaire has been prepared for this purpose distributed (72) to sample of management levels (Top, middle) in the General company for mining industries and aquatic Insullation & the General company of batteries industry, The research has tried to test a number hypotheses related to the relation and regression among the variables of the research, and the differences among the <
... Show MoreThe present study aims at knowing the effect of discussion method for students of fifth grade in preparatory school.
Methodology of the Study:
In order to achieve the objective of the study, the researcher chooses non-randomly the preparatory school affiliated to the District Chamchamal \ Suliemnaniya. The sample attained 64 students in 32 per group (control and experimental) groups. The researcher used the discussion method which was applied on experimental group. She uses the traditional method on the control group.
The researcher matched the two group in ago, intelligence, marks at the Kurdish Language in the previous year , pretest and posts for the indepe
... Show MoreAbstract:
This research aims to identify the impact of the Layout Ghazi al-Hariri hospital for surgery specialist on customer satisfaction (patients) using the model (Servicescape), the problem of the research represented in the extent to which the hospital management design of the service and Layout hospital aesthetic and functional aspects that fit patients for therapeutic and nursing services , and used the developer scale by (Miles et al., 2012) for data collection, which includes the independent variable in (17) items distributed in three dimensions (Facility aesthetics , hospital cleanliness, and the Layout accessibility ) The dependent variable is the satisfaction of customers (pat
... Show MoreThe study aimed to determine the effect of the flipped learning model in improving the acquisition of the overhand serve skill in volleyball among second-year students at the College of Physical Education and Sport Sciences, University of Baghdad, for the academic year 2024/2025. The study used an experimental design with a control group and pre-post testing, on a purposive sample consisting of 12 students. The model relied on watching short videos before class via the SGS application, and practical application in class at a rate of three sessions per week. The results showed a significant improvement in performance, as the calculated value (t = 5.356) exceeded the tabulated value (2.042) at a significance level of 0.05. The percentage of s
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