Comparison of a Peripheral Nerve Block versus Spinal Anesthesia in Foot or Ankle Surgery: A Systematic Review and Meta-Analysis with a Trial Sequential Analysis

Background: This systematic review and meta-analysis with trial sequential analysis (TSA) aimed to compare perioperative outcomes of peripheral nerve blocks (PNBs) spinal anesthesia (SA) in elective foot ankle surgery. Methods: The study protocol was registered PROSPERO (CRD42021229597). Researchers independently searched PubMed, EMBASE, the Cochrane Central Register Controlled Trials for relevant randomized controlled trials (RCTs). Results: Analysis nine RCTs (n = 802; 399 PNBs, 403 SA) revealed significantly shorter block performance times (WMD: 7.470; 95% CI 6.072 8.868), onset sensory 7.483; 2.837 12.130) motor 9.071; 4.049 14.094), durations 458.53; 328.296 588.765) 247.416; 95.625 399.208), higher postoperative analgesic requirements (SMD: −1.091; −1.634 −0.549) SA group. Additionally, systolic blood pressure (SBP) at 30 min 13.950; 4.603 23.298) lower Conclusions: demonstrated time, faster duration blocks, requirements, SBP compared PNBs