ABSTRACT
Aim: 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 II, III scheduled foot or ankle surgery
Patients were randomly allocated into 3 equal groups (30 patients in each group):
Group I: received epidural anesthesia.
Group II: received popliteal nerve block (posterior approach) contains 0.5% plain bupivacaine plus
morphine 2 mg +ketorolac 30 mg (Total volume 30 ml).
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.