Intravenous Regional Anesthesia Using a Forearm Tourniquet: A Safe and Effective Technique for Outpatient Hand...

Area of Science:

• Anesthesiology
• Regional Anesthesia
• Orthopedic Surgery

Background:

• Bier block anesthesia offers limb anesthesia without surgical site injection.
• It allows for multiple procedures and incisions by anesthetizing a wide area.
• A low-volume Bier block with a forearm tourniquet is proposed as a safe alternative.

Purpose of the Study:

• To evaluate the safety, tolerability, and effectiveness of low-volume Bier block with a forearm tourniquet.
• To assess its suitability for outpatient hand procedures.

Main Methods:

• Retrospective review of 319 adult patients undergoing hand procedures with Bier block anesthesia.
• Data collection included demographics, procedures, complications, tourniquet details, and medications.
• Analysis of tourniquet time, discharge time, and supplemental medication use.

Main Results:

• Carpal tunnel release and trigger digit release were the most common procedures.
• A single complication (0.3%) of transient paresthesias and tinnitus was reported.
• Average tourniquet time was 24 minutes, with a median postoperative discharge of 49 minutes.

Conclusions:

• Forearm tourniquet Bier block provides effective regional anesthesia for outpatient hand surgery.
• The technique is well-tolerated, has a low complication rate, and facilitates timely patient discharge.
• Consideration for this method in outpatient hand procedures is recommended.