Bier Block (Intravenous Regional Anesthesia)
Intravenous regional anesthesia is one of the oldest anesthetic techniques still in use today. More than 100 years of experience attest to its safety and utility in a wide variety of procedures - Cody Rowan MD and Elizabeth Wilson MD
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Intravenous Regional Anesthesia: A New Look at an Old Technique
More than a century has passed since Dr August Bier first described vein anesthesia as a rapid-onset anesthetic technique for extremity surgery. The process required exsanguination of the extremity, application of a tourniquet, vascular cutdown for access, and administration of local anesthetic. The technique was considered cumbersome, and with the introduction of brachial plexus blockade, it was largely forgotten. However, in 1963, C. Holmes published a case series in Lancet using diluted lidocaine for intravenous anesthesia, thus reviving interest in the anesthetic technique.
Articles of Interest
Bier Block
Since Bier’s initial introduction of this method of anaesthesia it has been substantially modified and protocols for Biers block differ depending on the country, local protocols and which limb is undergoing the procedure.
Intravenous Regional Block for Upper and Lower Extremity Surgery
The technique of intravenous regional anesthesia (IVRA), or “Bier block,” was first introduced in 1908 by the German surgeon August Bier. A Bier block essentially consists of injecting local anesthetic solutions into the venous system of an upper or lower extremity that has been exsanguinated by compression or gravity and that has been isolated by means of a tourniquet from the central circulation.
Resources
StatPearls
The Bier block, also known as intravenous local anesthesia (IVRA), is a safe, effective, and cost-efficient way to provide short-term anesthesia and analgesia during surgery on an extremity. This technique requires minimal additional equipment and can be performed in a variety of clinical environments.
