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1 results

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

  • Bruce Mohr
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 8 / Issue 4 / July 2006
    Published online by Cambridge University Press:
    21 May 2015, pp. 247-250
    Print publication:
    July 2006
    • Article
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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.