الفهرس 
Anatomy of Lumbar PlexusOnly 14 pages are availabe for public view
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Abstract
Summary
Every day, clinical practice for regional anesthesia confirms
its security and value for perioperative pain control.
All patients with femoral fractures are optimal candidates for
3-in-1 FNBs. The FNB is especially helpful in patients with
significant opiate tolerance, opiate allergy and patients with comorbidities
Inconsistent block success and procedure related
complications have been reduced with the introduction of ultrasound
in regional anesthesia practice.
Levobupivacaine the S-enantiomer of racemic bupivacaine is
less cardiotoxic whereas showing similar local-anesthetic properties
and the potency of racemic bupivacaine.
The aim of the present study was to compare between
levobupivacaine and plain bupivacaine in ultrasound guided three in
one femoral nerve in patient undergoing unilateral lower limb
surgery.
Sixty patients of both sex of ASA physical status I and II
scheduled for unilateral lower limb surgery under three in one FNB
included in our study.
group I (levo – group):
Includes 30 patients received 0.25% plain bupivacaine at 0.5
ml/Kg as the three in one FNB.
group II (bupi- group):Includes 30 patients received 0.25% plain bupivacaine at 0.5
ml/Kg as the three in one FNB.
Routine monitoring (non-invasive blood pressure, heart rate,
oxygen saturation) were done before and during the procedure.
Onset of sensory and motor block, duration of sensory and
motor block, degree of sedation, postoperative pain, analgesic
requirements and the complications were recorded.
The results of our study showed that the ultrasound guided
three in one FNB was successful in all patients included with no
complications.
Also it showed that three in one FNB with levobupivacaine
had a faster onset of sensory and motor block and shorter duration of
motor block compared with bupivacaine, on the other hand both
drugs equal in terms of the duration of sensory block, postoperative
pain scores and the amount of the analgesia required.
Conclusion
Form the results of our study we can concluded that the use of
0.5 ml/Kg of levobupivacaine at a concentration of 0.25% in the
ultrasound guided three in one FNB achieved the same degree of
sensory block with less degree of motor block compared to the same
concentration of bupivacaine,