Effect of Ketorolac as an Additive to Lidocaine in Bier s Block for the Upper Limb Orthopedic Surgeries, the Safest and Most Effective Dose

Background: Regional anesthesia is being practiced safely with reduced risk. However, it is a limited technique due to lack of postoperative analgesia, time limit to surgical procedure and tourniquet pain.Objectives: To compare the operative duration and the first call for postoperative analgesia with adding different doses of Ketorolac to the Lidocaine in Bier s block as a primary end point, and the incidence of complications as a secondary end point.Study Design and Sample: This is a randomized double- blind controlled study which was conducted in the Department of Anesthesia, Kasr El-Aini Teaching Hospital, and Cairo University, Egypt in the period between October 2013 and October 2015 after approval of the Ethical Committee. Seventy six patients, aged 20-50 years, ASA I-II, both genders, scheduled for minor forearm and hand surgeries under IVRA were enrolled in the study.Methods: The patients were randomly allocated into four equal groups: Group Gl (n=19) received lidocaine in IVRA, group GKr10 (n=19) received lidocaine and Ketorolac 10mg mixture, group GKr20 (n=19) received lidocaine and ketorolac 20mg mixture and group GKr30 (n=19) received lidocaine and ketorolac 30mg. The operative duration, time to first call for analgesic postoperatively, and complications related to the drugs or technique were recorded.Results: There was an increase in the mean time to first call for analgesic in group GKr10 group GKr20 and GKr30 compared with group Gl (p 0.001). Group GKr30 had the longest duration of postoperative analgesia which was statis-tically significant compared to other groups (p 0.001). There were no significant complications recorded neither related to the drugs or technique were recorded.Conclusion: The use of Ketorolac as an adjuvant to Lidocaine in Bier s block resulted in improved postoperative analgesia with no complications.