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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: [email protected]

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

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