Effect of intravenous regional anesthesia with spinal block on foot surgeries: A double-blinded randomized clinical trial

Intravenous regional anesthesia is a simple and reliable method for surgeries of the lower extremities.  The purpose of this study was to compare the effect of regional intravenous anesthesia with spinal anesthesia on foot surgeries.

This study was conducted as a randomized clinical trial on 60 patients undergoing foot surgery in two similar groups. In this account, the intervention group received intravenous regional anesthesia with 40 mililitre of lidocaine (0.5%) and the control group underwent spinal anesthesia with marcaine (0.5%). Duration of analgesia, duration of postoperative analgesia after opening the tourniquet, recovery time, postoperative pain intensity based on Visual Analogue Scale (VAS), blood pressure, heart rate during the surgery and recovery period, and other complications such as nausea, vomiting and headache were assessed in both groups.

The two groups did not differ in age and sex. The mean duration of analgesia in the spinal group was 121.13±17.30 minutes and in the intravenous anesthesia group was 49.50±5.14 minutes (P<0.001). The mean duration of analgesia after opening the tourniquet was 72.17± 15.29 minutes in the control group and 11.17± 6.22 minutes in the intervention group (P<0.001). The mean recovery time in the control group was 26.83± 4.82 and in the intervention group was 13.10±3.20 min (P<0.001). One hour postoperative pain score was 2.3 ± 0.31 in the control group and 7.1± 0.20 in the intervention group (P<0.001).  Hypotension, bradycardia, nausea and vomiting, dizziness, and headache were more incidental in the spinal group than in the intravenous anesthesia group (P<0.001).

In short-term foot surgeries, intravenous regional anesthesia is more appropriate than intra-spinal