Background:Lumbar plexus block (LPB) is one of the anesthetic options in the elderly patients undergoing hip surgeries. LPB could be safe because it targets somatic nerve in psoas region. Effectiveness of LPB is attributed to the sufficient analgesia provided intraoperatively as well as postoperatively. Adequate muscle relaxation and immobility during surgery refers to its acceptability.Objectives:In this study, LPB was used as the anesthetic method to manage the elderly patients subjected to hip surgery.Patients and Methods:A total of 50 patients aged 51 to 100 years were enrolled in this study. LPB was accomplished after a mild sedation and with a modified method using patient's fingertip width (FTW) as the distance unit to determine needle entry point under electrical nerve stimulation assistance. After targeted injection, procedure time, establishment time, block duration, surgery time, hemodynamic variables, and surgeon satisfaction score were documented and analyzed. Propofol in trivial doses was infused intraoperatively to provide clinical sedation.Results:Mean patient's age was 73 ± 12 years with ASA II/III. Procedure time was 5.65 ± 1.24 minutes, establishment time was 130 ± 36 seconds, block duration was 13.1 ± 8 hours, surgery time was 149.7 ± 32.2 minutes, and surgeon satisfaction score was 9.8 ± 0.1. There was no complication and no failure. Hemodynamic stability was pleasantly achieved.Conclusions:By preserving hemodynamic stability, LPB in conjunction with a light sedation could be considered as a reliable prudent satisfying anesthetic option in management of hip fractures in the elderly patients with three beneficial characteristics of safety, effectiveness, and acceptability.

BackgroundPreemptive analgesia may be considered as a method not only to alleviate postoperative pain but also to decrease analgesic consumption. Different regimens are suggested, but there is currently no standard.ObjectivesThe aim was to measure the efficacy of preemptive analgesia with pregabalin, acetaminophen, naproxen, and dextromethorphan in radical neck dissection surgery for reducing the intensity of pain and morphine consumption.Patients and MethodsThis study was conducted as a randomized double-blind clinical trial. Eighty adult patients (18 to 60 years of age) under the American society of anesthesiologists (ASA) physical status I and II undergoing elective radical neck dissection were enrolled. Patients were randomized into two groups of 40 with a simple randomization method. The case group received a combination of 15 mg/kg acetaminophen, 2.5 mg/kg pregabalin, 7 mg/kg naproxen, and 0.3 mg/kg dextromethorphan administered orally one hour prior to surgery. Postoperative pain was assessed with the universal pain assessment tool (UPAT) at 0, 2, 4, 6, 12, and 24 hours after surgery. Subjects received morphine based on postoperative pain control protocol. Total administered morphine doses were noted.ResultsPostoperative pain rates at 0, 2, 4, 6, 12, and 24 hours after surgery were significantly lower for the case group than the control group (P values = 0.014, 0.003, 0.00, 0.00, and 0.00, respectively). Total morphine doses for the preemptive analgesia group were 45% lower than those of the other group. Side effects were similar for both groups.ConclusionsA single preoperative oral dose of pregabalin, acetaminophen, dextromethorphan, and naproxen one hour before surgery is an effective method for reducing postoperative pain and morphine consumption in patients undergoing radical neck dissection.

BackgroundHip fracture–related pain both before and after surgery is generally reported as severe by most patients. Various regional pain control modalities have been described in order to reduce pain in these patients.ObjectivesBecause of the challenges of lumbar plexus block (LPB) and the fact that the effect of combined femoral nerve block/spinal anesthesia in controlling pain after orthopedic surgeries has not been investigated, in this study, we compared the feasibility and efficacy of the 2 techniques in the perioperative management of proximal hip fractures.Patients and MethodsThe study included 32 patients with femoral intertrochanteric fracture who were randomly divided into the following 2 groups of 16 patients each: combined femoral nerve block/spinal anesthesia group (group I) and LPB group (group II). Patients in group I received 0.17% bupivacaine with 0.7% lidocaine, 20–25 mL for femoral nerve block and bupivacaine 0.5% plus 0.5 mL pethidine (25 mg) for spinal block and patients in group II received 0.17% bupivacaine with 0.7% lidocaine, 30–35 mL.ResultsThe time for performing the block (12.2 ± 3.3 vs. 4.93 ± 1.6 min, P = 0.001) and achieving the block (7.7 ± 0.9 vs. 2.4 ± 1.0 min, P = 0.001) were significantly longer in the combined femoral nerve block/spinal anesthesia group than in the LPB group. Duration of analgesia in the combined femoral nerve block/spinal anesthesia group was longer than that in the LPB group, but the difference was not significant (17 ± 7.3 vs. 16.5 ± 8.5 h, P = 0.873). There were no significant differences in hemodynamic parameters regarding the method of anesthesia in the 2 groups.ConclusionsThis study confirms that the combination of femoral nerve block with spinal anesthesia is safe and comparable with LPB and can provide more effective anesthesia and longer lasting analgesia for intertrochanteric surgery.

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This study demonstrates the efficacy and safety of the ultrasound-guided supraclavicular brachial plexus block for orthopedic upper extremity surgeries in patients younger than 6 years of age.

The main objective in production blasting is to achieve a proper fragmentation. In this paper, rock fragmentation the Sarcheshmeh copper mine has been predicted by developing a model using artificial neural network. To construct the model, parameters such as burden to spacing ratio, hole-diameter, stemming, total charge-per-delay and point load index have been considered as input parameters. A model with architecture 9-8-5-1 trained by back propagation method was found to be optimum. To compare performance of the neural network, statistical method was also applied. Determination coefficient (R 2 ) and root mean square error were calculated for both the models, which show absolute superiority of neural network over traditional statistical method.

In this paper, yarn pull-out testing was performed to estimate the pulling-out force and the friction coefficient. Fabrics were impregnated with Shear Thickening Fluid (STF) of two types. Single fibre tensile tests were performed to determine the resistance of each fibre. The speed of pulling out was 500 mm/min and the samples were placed horizontally in a tensile device. The results indicated that the fabric impregnated in STF needed more force in order to get out of the fabric. Friction coefficients of three fabric types of raw fabric, fabric with dissolved fluid and fabric with STF were entered into an explicit dynamics finite element model along with the mechanical characteristic of a yarn. Ballistic range velocity was extracted for samples by the software and was compared with experimental results. The effects of the shear thickening fluid (STF) were considered as frictional effects.

Background & objectives:Multiple sclerosis (MS) is common in some ethnic groups. Interleukin-10 (IL-10) is a potent anti-inflammatory and immunosuppressive cytokine that may be an important regulator in MS disease pathogenesis. IL-10 promoter includes several single nucleotide polymorphisms and the level of IL-10 expression is related to these polymorphisms. Furthermore, loci within the histocompatibility regions are responsible for susceptibility to MS. The aim of this study was to investigate the association of IL-10 gene promoter polymorphisms and HLA-DRB1*15 allele frequencies with MS susceptibility in an Iranian population.Methods:In this study 336 MS patients and 454 healthy controls were included. Genomic DNA was purified from peripheral blood samples by a standard protocol. Genotyping was performed by the sequence-specific primer polymerase chain reaction method.Results:IL-10 −1082 G/G and IL-10 −819 C/C genotypes were more frequent in MS patients than healthy individuals. DRB1* 15 allele showed a higher frequency among MS patients compared to controls.Interpretation & conclusions:The IL-10 and HLA-DRB1*15 polymorphisms were associated with the susceptibility to MS in Iranian patients. Our results suggest that gene-gene interaction of IL-10 polymorphisms and HLA-DRB1*15 alleles may be important factors in the development of MS.