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A Bier block is a type of intravenous regional anesthesia that involves administering a local anesthetic into an upper extremity while blocking venous return with an inflated cuff. To assess its safety and effectiveness, this author retrospectively reviewed cases of Bier block performed by family physicians for outpatient management of forearm injuries. The study was conducted at a freestanding emergency facility in Canada.
To perform a Bier block, physicians administered 1.5 to 3.0 mg/kg of 0.5% lidocaine through an indwelling catheter after inflating a distal blood pressure cuff to at least 250 mm Hg. The cuff was left in place for 30 to 90 minutes and then deflated using a “deflation/reinflation” technique to minimize the possibility of r…