A Modern Approach to the Bier Block Technique

Yari, Shahram S; Hafkin, Jonas; Khan, Jawad; Netscher, David T.

doi:10.1007/s42399-020-00456-0

Cited by 4 publications

(1 citation statement)

References 9 publications

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“…Moreover, there are no clear guidelines on minimum "safe" tourniquet times in IVRA [1,2,24]. However, some studies have recommended a minimum tourniquet time of 30 min to minimize pharmacological toxicity when high doses of local anaesthetics are administered [4,7,25]. Gurich et al conducted a retrospective study of 430 patients who underwent upper arm IVRA and reported that although the tourniquet time was less than 20 min in all patients, no major complications were noted [24].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Low Doses of Lidocaine in Terms of Efficacy, Reliability, and Satisfaction in Ambulatory Hand Surgery Using Intravenous Regional Anaesthesia with Forearm Tourniquet: A Prospective, Randomized Controlled Trial

Erdal Erbatur,

Ozdemir,

Tiryaki

et al. 2024

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Objective: This study aimed to assess efficacy, complications, and surgeon and patient satisfaction related to forearm intravenous regional anaesthesia using low doses of lidocaine in ambulatory hand surgery. Methods: This prospective, randomized and double-blind study included patients who received 25 ml (125 mg; Group 1; n = 35) and 15 ml (75 mg; Group 2; n = 35) of 0.5% lidocaine. Data recorded included sociodemographic variables, intraoperative hemodynamic findings, time to onset of sensory and motor block, intensity of motor block, duration of tourniquet tolerance, need for additional local anaesthetic and sedation, development of intraoperative complications, perioperative visual analog scale values, and patient and surgeon satisfaction. Results: Group 2 showed significantly longer time to onset of motor and sensory block than Group 1 (p = 0.033 and 0.015, respectively). Group 2 showed a significantly weaker intensity of motor block than Group 1 (p < 0.001). Only one patient in Group 2 required additional local anaesthetic. No patient developed major complications. Conclusion: Forearm intravenous regional anaesthesia using a low dose of 0.5% lidocaine (75 mg; 15 ml) can provide adequate and safe surgical anaesthesia in ambulatory surgery of the hand. Furthermore, weaker motor blockade may assist the surgical team, especially in tendon surgeries. Therefore, the use of a lidocaine dose almost equivalent to the quantity used in IV induction of anaesthesia can achieve safe and effective anaesthesia in hand surgery. Level of Evidence: Level I, therapeutic study.

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Section: Discussionmentioning

confidence: 99%

Comparison of Low Doses of Lidocaine in Terms of Efficacy, Reliability, and Satisfaction in Ambulatory Hand Surgery Using Intravenous Regional Anaesthesia with Forearm Tourniquet: A Prospective, Randomized Controlled Trial

Erdal Erbatur,

Ozdemir,

Tiryaki

et al. 2024

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General Topics: Bier block

Prem

Anand

2022

Anesthesiology in-Training Exam Review

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The pharmacist’s role in reducing infusion-related phlebitis

Johnson

Norton

Fryfogle

et al. 2023

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Pharmacists oversee parenteral drug preparation and administration in hospitals, clinics, infusion centers, and home infusion settings. Infusion-related phlebitis (IRP), the most common complication of intravenous infusion therapy, significantly impacts therapeutic outcomes, patient satisfaction, cost of care, and provider workload. Here we review the major etiologies of IRP and describe potential pharmacological and nonpharmacological interventions for preventing and managing the condition as well as for improving vascular access health in multiple-drug administration settings. Summary Many parenterally administered drugs cause phlebitis due to mechanical, chemical, or infectious etiologies. Pharmacists can recommend nonpharmacological strategies to mitigate phlebitis, including judicious device selection and placement; adjustment of the drug concentration, flow rate, or formulation; infusion site rotation; and use of inline filters to minimize contaminant particulates. Pharmacological treatments for phlebitis include topical, local, and systemic anti-inflammatory and analgesic agents that can reduce symptom severity and prevent further treatment complications or delays. Conclusion Pharmacists can contribute a unique perspective to interprofessional teams tasked with making policy and formulary decisions that minimize the negative impacts of IRP on drug delivery and patient outcomes.

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A Modern Approach to the Bier Block Technique

Cited by 4 publications

References 9 publications

Comparison of Low Doses of Lidocaine in Terms of Efficacy, Reliability, and Satisfaction in Ambulatory Hand Surgery Using Intravenous Regional Anaesthesia with Forearm Tourniquet: A Prospective, Randomized Controlled Trial

Comparison of Low Doses of Lidocaine in Terms of Efficacy, Reliability, and Satisfaction in Ambulatory Hand Surgery Using Intravenous Regional Anaesthesia with Forearm Tourniquet: A Prospective, Randomized Controlled Trial

General Topics: Bier block

The pharmacist’s role in reducing infusion-related phlebitis

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