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Analgesia and Anaesthesia
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Although performed much less commonly than it once was, the Bier’s block is a useful technique in carefully selected patients. It involves the injection of local anaesthetic into an exsanguinated limb distal to a pneumatic tourniquet. Intravenous regional anaesthesia is used in the upper limb and is an effective means of providing anaesthesia for short procedures on the hand and forearm. The duration of the procedure is limited by the discomfort caused by the tourniquet and is usually no more than 1 hour. Tourniquets should be avoided in patients with sickle cell disease or trait, Raynaud’s disease or symptomatic peripheral vascular disease.
Orthopaedic Emergencies
Published in Anthony FT Brown, Michael D Cadogan, Emergency Medicine, 2020
Anthony FT Brown, Michael D Cadogan
Bier's block technique of intravenous regional anaesthesia (see p. 485). Rest the patient for at least 2 h after completion while regular observations are made. Allow home with an accompanying adult if the plaster is comfortable and the patient feels well.
Pharmacology of local anesthetics
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2014
Pamela E. Macintyre, Stephan A. Schug
Prilocaine has a similar clinical profile to lidocaine (lignocaine), but is the least toxic of the amide local anesthetic drugs. This makes it a most suitable choice for intravenous regional anesthesia (Bier’s block).
Comparison of Effects of Levobupivacaine and Ropivacaine Infiltration on Cutaneous Wound Healing in a Rat Model
Published in Journal of Investigative Surgery, 2018
Cihangir Biçer, Yalcin Yontar, Günhan Gökahmetoğlu, Teoman Eskitaşçıoğlu
The use of long-acting anesthetic agents during surgical procedures performed under local or general anesthesia improves the management of postoperative pain and reduces the need for systemic analgesic medications due to their long duration of action [12]. For several decades, bupivacaine has been the most widely used long-acting anesthetic agent for the purposes of infiltration anesthesia, intravenous regional anesthesia, and peripheral and central nervous blockades [13, 14]. Despite its low toxicity in relation to cutaneous wound healing [9, 15-17], intravascular injection of bupivacaine has been demonstrated to have severe systemic toxic effects on cardiac activity and the central nervous system, including dysrhythmia, hypotension, depression of cardiac output, visual and hearing disturbances, dysarthria, muscular rigidity, muscular twitching, and seizures [6, 13]. Such toxicities of bupivacaine promoted the more recent development of two novel long-acting anesthetics agents with relatively lower systemic toxicity, levobupivacaine and ropivacaine [14].
Effect of the use of dexmedetomidine as an adjuvant in peribulbar anesthesia in patients presented for vitreoretinal surgeries
Published in Egyptian Journal of Anaesthesia, 2018
Sameh Abdelkhalik Ahmed, Mohamad Gamal Elmawy, Amr Ahmed Magdy
In contrast to the results of our study, Esmaoglu et al. [30], who revealed that addition of dexmedetomidine to lidocaine in intravenous regional anesthesia wasn't associated with any effect on the duration of either sensory or motor blockade. Also, Gandhi et al. [31], concluded that the use of dexmedetomidine as a local anesthetic adjuvant in supraclavicular brachial plexus block delayed the onset of sensory and motor block. However, they were in agree with our findings that the use of dexmedetomidine decreased the postoperative pain and the need for analgesics.
Ketamine versus neostigmine as adjuvants to bupivacaine during ultrasound-guided serratus anterior plane block in modified radical mastectomy. A randomized controlled trial
Published in Egyptian Journal of Anaesthesia, 2021
Bassant Mohamed Abdelhamid, Samuel Samy, Ahmed Abdalla, Ahmed Saad, Mohamed Ollaek, Abeer Ahmed
In a study by McCartney et al., 2003 [23], authors demonstrated that adding 1 mg neostigmine to 0.5% lidocaine during intravenous regional anesthesia has no anesthetic or analgesic effect. Another study by Bouaziz et al., 1999 [24] revealed that 500 mcg of neostigmine did not affect sensory and motor block in both axillary block and subcutaneous wound infiltration. On the other hand, Bouderka et al., 2003 [25] demonstrated a lower pain score and decreased postoperative analgesic requirement when 500 mcg neostigmine was added to the axillary plexus block.