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Bier's block using prilocaine: safe, cheap and well tolerated
1Department of Trauma and Orthopaedic Surgery, University Hospital, Queen's Medical Centre, Nottingham, NG7 2UH, UK. simonpickering@tiscali.co.uk
Summary
Prilocaine Bier's block is a safe and effective anesthesia for Colles fracture manipulation, showing high patient satisfaction. This method for distal radial fracture reduction is well-tolerated, with minimal adverse events reported.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Trauma Care
Background:
- Colles fractures are common wrist injuries requiring manipulation.
- Anesthesia choice impacts patient outcomes and satisfaction during fracture reduction.
Purpose of the Study:
- To evaluate the safety and patient satisfaction of prilocaine Bier's block for Colles fracture manipulation.
- To assess the incidence of adverse events associated with this anesthetic technique.
Main Methods:
- Retrospective review of 7410 patients undergoing Colles fracture manipulation with prilocaine Bier's block.
- Analysis of neurological and cardiovascular events.
- Administration of a satisfaction questionnaire to 50 patients.
Main Results:
- No documented anaphylaxis, arrhythmia, convulsions, or collapse.
- High patient satisfaction (48/50 satisfied).
- Pressure cuff inflation identified as the least comfortable aspect.
Conclusions:
- Prilocaine Bier's block is a safe anesthetic option for distal radial fracture reduction.
- The procedure demonstrates high patient satisfaction, comparable to other anesthetic methods.
- Safe execution is feasible by a single practitioner with adequate monitoring and support.