Identify the type of nerve block shown in the image.
Brachial Plexus Block
Ans:D.) Bier’s Block.
- Also referred to as “INTRAVENOUS REGIONAL ANAESTHESIA”.
- Provides intense anesthesia for short cases (45-60 minutes) on the forearm or hand.
- A double pneumatic tourniquet is placed on the arm after an IV is started in the hand.
- The arm is elevated and exsanguinated, the proximal tourniquet is inflated above systolic pressure.
- So that no blood can enter in that limb and it remains exsanguinated.
- Lidocaine without adrenaline is the DOC for the technique.
- A few clinicians prefer prilocaine over lidocaine because of its higher therapeutic index – least toxic LA.
- Tornique cuff deflation, premature release or failure of tourniquet can cause release of LA into circulation and toxicity may occur.
- Anesthesia is achieved after 5-10 minutes.
- After 20-30 minutes tourniquet pain develops, at which point the distal tourniquet (which is over anesthetized skin) is inflated and the proximal cuff is deflated.
- So, cardiotoxic LAs like bupivacaine and etidocaine are contraindicated for Bier’s block.