INTRAVENOUS REGIONAL ANESTHESIA FOR OUTPATIENT FOOT AND ANKLE SURGERY- A PROSPECTIVE-STUDY

A prospective study was undertaken in 39 patients undergoing 48 foot a nd ankle procedures using intravenous regional anesthesia (IVRA). IVRA was administered using 35 cc of 0.33% or 0.5% lidocaine. Single tourn iquets inflated to 250 mm Hg were used at the ankle level. No suppleme ntal analgesia or sedation was used. Those requiring supplemental loca l anesthetic infiltration were defined as IVRA failures. Thirty-one of the 39 patients (79.5%) tolerated the procedures with tittle or no di scomfort, and 8 (20.5%) required additional local infiltration with 1% lidocaine. All 39 patients completed the procedures at the outpatient surgical unit without requiring conversion to other forms of anesthes ia. Patchy non-anesthetic areas were noted in 14 patients (36.8%). In 7 patients, because the non-anesthetic areas were excluded from the op erative fields, the procedures were completed without discomfort. Howe ver, in 8 patients where the nonanesthetic areas were directly involve d in the operative fields, supplemental local anesthesia was required. Only 1 of the 39 patients complained of tourniquet pain. IVRA compare d favorably with other methods of regional anesthesia in the lower ext remity with respect to ease of technique, speed of onset, safety, and patient acceptance. However, it appears that it is less reliable than IVRA in the upper extremity. The reasons for this difference will requ ire further investigation.