Publications of Faculty of Medicine:The effect of addition of local or intravenous ketorolac and morphine as an adjuvant to local anesthetic in popliteal nerve block. A comparative study with epidural anesthesia for foot or ankle surgery in diabetic patient : Abstract

The aim is to study the effect of addition of ketorolac and morphine as an adjuvant to local anesthesia in popliteal nerve block in comparison with epidural anesthesia for foot or ankle surgery in diabetic patients Patients and method: The study was done on 90 diabetic patients ASA 11, 111 scheduled foot or ankle surgery Patients were randomly allocated into 3 equal groups (30 patients in each group): Group I: received epidural anesthesia. Group H: received popliteal nerve block (posterior approach) contains 0.5% plain bupivaraine plus morphine 2 mg +ketorolac 30 mg (Total volume 30 m1). Group III: received popliteal nerve block (posterior approach) contains 0.5% plain bupivacaine (Total volume 30 ml) plus I.V. morphine 2 mg +ketorolac 30 mg. The following parameters were recorded: (1) Onset of block. (2) Analgesia duration. (3) Early mobilization. (4) Time for hospital discharge. (5) Side effects. Results: : Group II has decreased onset of block, long duration of analgesia, early mobilization, less hospital discharge time and less side effects in comparison with groups I and III. Conclusion: Popliteal nerve block with local adjuvants (Morphine and ketorolac) compared with epidural analgesia results in decreased onset, faster mobilization, and earlier time for hospital discharge with minimal side effects. Ketorolac and morphine are more efficient when given locally than systemically. Introduction