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Intravenous regional anesthesia (IVRA) or Bier's block anesthesia is an anesthetic technique on the body's extremities where a local anesthetic is injected intravenously and isolated from circulation in a target area.
The axillary block is particularly useful in providing anesthesia and postoperative analgesia for surgery to the elbow, forearm, wrist, and hand. The axillary block is also the safest of the four main approaches to the brachial plexus, as it does not risk paresis of the phrenic nerve, nor does it have the potential to cause pneumothorax. [12]
Use in paracervical blocks in obstetrics is also contraindicated. Levobupivacaine is furthermore contraindicated in patients with known hypersensitivity to levobupivacaine or other amide-type local anaesthetics, in patients with severe hypotension (e.g. cardiac or hypovolemic shock) and for use in intravenous regional anaesthesia (Bier’s block).
Many local anesthetics fall into two general chemical classes, amino esters (top) and amino amides (bottom). A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, [1] providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation in the entire body and causes ...
The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, [1] are guidelines published by the American Geriatrics Society (AGS) for healthcare professionals to help improve the safety of prescribing medications for adults 65 years and older in all except palliative settings.
Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, [1] is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long.
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In 1908, Bier pioneered the use of intravenous regional anesthesia, [2] [3] a technique which is commonly referred to as a "Bier block". [4] This technique is frequently used for operations of brief duration upon the hand, wrist, and forearm. It can also be used for operations of brief duration upon the foot, ankle, and leg. [2] [3]