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Safety and effectiveness of intravenous regional anesthesia (Bier block) for outpatient management of forearm trauma

Published online by Cambridge University Press:  21 May 2015

Bruce Mohr
Bruce Mohr*
Affiliation:
Whistler Health Care Centre, Whistler, BC
*
4380 Lorimer Rd., Whistler BC V0N 1B4: bruce.mohr@vch.ca

Abstract

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Objective:

To assess the safety and effectiveness of intravenous regional anesthesia (Bier block) in the management of forearm injuries (i.e., forearm, wrist or hand) by primary care physicians at a diagnostic and treatment facility.

Methods:

A retrospective review was conducted of all patients at a single centre who underwent a Bier block for forearm injuries between September 2000 and March 2005.

Results:

1816 Bier blocks were performed on 1804 patients (64% male) during the study period. Patient age ranged from 4–70 (mean 25) years. Wrist fractures requiring reduction were the most common diagnosis. Adverse events were recorded in 9 cases (0.50%, 95% confidence interval 0.23%–0.94%): 1 case of medication error (0.06%); 3 of improper cuff inflation (0.17%); and 5 of inadequate analgesia (0.28%). None of the adverse events resulted in failure to complete the procedure or in serious morbidity or mortality.

Conclusion:

Bier block anesthesia is a safe, effective and reliable technique in an outpatient primary care setting. This technique is a useful modality for physicians who manage acute upper-extremity injuries.

Keywords

intravenous regional anesthesiaBier blockforearm injuriesoutpatient managementprimary carediagnostic and treatment facility
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 8 , Issue 4 , July 2006 , pp. 247 - 250
Copyright
Copyright © Canadian Association of Emergency Physicians 2006

References

1.Roberts, JR, Hedges, JR, editors. Clinical Procedures in Emergency Medicine. 2nd ed. Philadelphia: Saunders; 1991. p. 499–503.Google Scholar
2.Casey, WF. Intravenous regional anaesthesia (Bier’s block). Update Anaesthesia 1992;1:1–3. Available: www.nda.ox.ac.uk/wfsa/html/u01/u01_003.htm (accessed 2006 May 30).Google Scholar
3.Olney, BW, Lugg, PC, Turner, PL, et al. Outpatient treatment of upper extremity injuries in childhood using intravenous regional anesthesia. J Pediatr Orthop 1988;8:576–9.Google Scholar
4.Bolte, RG, Stevens, PM, Scott, SM, et al. Mini-dose Bier block intravenous regional anesthesia in the emergency department treatment of pediatric upper-extremity fractures. J Pediatr Orthop 1994;14:534–7.Google Scholar
5.Blasier, RD, White, R. Intravenous regional anesthesia for management of children’s extremity fractures in the emergency department. Pediatr Emerg Care 1996;12:404–6.Google Scholar
6.Farrell, RG, Swanson, SL, Walter, JR. Safe and effective regional anesthesia for use in the emergency department. Ann Emerg Med 1985;14:239–43.CrossRefGoogle ScholarPubMed