Tuesday, June 28, 2011

Bier's block

August Bier- surgeon 1900s (prilocaine)

now: lidocaine
for surgeries <1 hr

double cuff tourniquet
IV cannula
Esmarch bandage
exsanguinate
inflate distal cuff then proximal cuff then deflate distal cuff
SBP 100mmHg above systolic p
lignocaine through IV cannula (12-15 ml of 2% vs 20ml of 0.5% )

deflate for 10seconds, reinflate 1 min then deflate again

disadvantages:
- tourniquet pain for longer ops
- no post op analgesia

No comments:

Post a Comment