Understanding Anesthesiology - The Global Regional Anesthesia ...

Bier Block
An intravenous regional anesthetic (IVRA or “Bier block”) is a technique introduced by
August Bier in 1908 and still in use today. The operative limb (arm or leg) is “exsanguinated”
using gravity and an elastic bandage after which an arterial cuff is inflated proximally
to maintain exsanguination. Subsequently to exsanguination, large volumes of dilute
lidocaine are injected (through a small cannula that is placed prior to exsanguination) into
the affected limb.
Surgical anesthesia can last for 60-90 minutes, usually limited by the pain created by the inflated
cuff. It is important that the cuff pressure be maintained for at least 30 minutes to
avoid a sudden bolus of local anesthetic being introduced into the systemic circulation.
Related Glossary Terms
Brachial plexus block, Intravenous regional anesthetic, Lidocaine, Local anesthetic toxicity,
Regional anesthesia
Index
Find Term
Chapter 3 - Regional Anesthesia