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The "mini-Bier's block": a new technique for prevention of tourniquet pain during axillary brachial plexus anaesthesia.

Abstract
Tourniquet cuff pain is a significant cause of morbidity following regional anaesthesia of the upper limb. We describe a simple new technique for effectively anaesthetizing the area under a pneumatic tourniquet (the "mini-Bier's block"), which permits comfortable surgery under axillary block anaesthesia even if the local block is incomplete. We report a controlled study of 40 patients in whom statistically significant tourniquet cuff pain relief was obtained in patients receiving an additional low-dose intravenous injection of local anaesthetic localized beneath the cuff. This technique ensures that the safe axillary approach to the brachial plexus can always be used with avoidance of pain from the pressure of the tourniquet cuff.
AuthorsN K James, C T Khoo, R H Fell
JournalJournal of hand surgery (Edinburgh, Scotland) (J Hand Surg Br) Vol. 19 Issue 3 Pg. 347-9 (Jun 1994) ISSN: 0266-7681 [Print] Scotland
PMID8077826 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Lidocaine
  • Bupivacaine
Topics
  • Adolescent
  • Adult
  • Axilla (innervation)
  • Axillary Artery
  • Brachial Plexus
  • Bupivacaine (administration & dosage)
  • Elbow (blood supply)
  • Female
  • Humans
  • Lidocaine (administration & dosage)
  • Male
  • Middle Aged
  • Nerve Block (methods)
  • Pain (prevention & control)
  • Pressure (adverse effects)
  • Time Factors
  • Tourniquets (adverse effects)

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