Technique of Intravenous Regional Block for Complex Regional Pain Syndrome Using Methylprednisolone, Lidocaine, and Labetalol.

Intravenous regional block (IVRB), adapted from the Bier block technique, is a minimally invasive, low-risk interventional option for complex regional pain syndrome (CRPS). This technical report describes a reproducible IVRB protocol using methylprednisolone, lidocaine, and labetalol and emphasizes procedural details that may influence treatment delivery. Key elements include obtaining venous access distal to the involved region, selecting tourniquet position and pressure according to the affected extremity, slowly infusing the injectate, and performing deep friction massage while the extremity remains isolated from the systemic circulation. The report also describes staged tourniquet deflation, the use of anesthesia to limit procedure-related pain, an initial series of repeated blocks before judging response, and subsequent adjustment of block frequency according to the duration of pain relief. Practical methods for obtaining venous access in an edematous hand or foot and approaches to patients with remission, palliation, or an inadequate response are discussed. The objective is to provide clinicians with a detailed technique that can be reproduced and critically evaluated in the treatment of CRPS.