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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Related Experiment Video

Updated: Jun 6, 2026

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Electrophysiological Methods to Assess Peripheral Pain Block in an Anesthetized Rat

Published on: November 21, 2025

Continuous peripheral nerve blocks in acute pain management.

J E Chelly¹, D Ghisi, A Fanelli

¹Division of Regional Anesthesia and Acute Interventional Perioperative Pain Service, Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. chelje@anes.upmc.edu

British Journal of Anaesthesia

|December 15, 2010

Summary

Continuous nerve blocks offer safe and effective pain management beyond orthopaedics, reducing opioid use and hospital stays. These techniques are crucial for perioperative analgesia across various surgical procedures.

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Area of Science:

Anesthesiology
Pain Management
Surgical Care

Background:

Continuous nerve blocks (CNBs) are increasingly used for perioperative pain management.
Indications have expanded beyond orthopaedics to include diverse surgical specialties.

Purpose of the Study:

To review the expanded indications and benefits of CNBs in perioperative pain management.
To highlight the safety and efficacy of CNBs compared to traditional methods.

Main Methods:

Review of current literature and clinical practices regarding CNBs.
Analysis of infusion regimens considering patient condition and surgical stress.

Main Results:

CNBs are effective for major upper/lower extremity, abdominal, plastic, urological, gynaecological, thoracic, and trauma surgeries.
CNBs reduce opioid consumption, side-effects, and length of hospital stay.
CNBs offer a safer alternative to epidural analgesia for patients on thromboprophylaxis.

Conclusions:

Continuous nerve blocks are a versatile and effective tool for perioperative pain management across numerous surgical fields.
These techniques improve patient recovery and safety, particularly for those on anticoagulation therapy.