#36262 Bier blocks in ambulatory surgery: a wellcomed comeback or old news?

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Background and Aims

Intravenous regional anesthesia, commonly known as Bier Block (BB), consists of administering a local anesthetic into the venous system of an exsanguinated limb that is isolated from the systemic circulation by a tourniquet. It is a simple technique that does not require the use of an ultrasound device, provides a blockade that is quickly installed and reversed and a surgical field with minimal blood loss. For this reasons it has a lot o potencial in ambulatory surgery.

Methods

We gathered perioperative information concerning every adult patient that was subjected to a BB in Egas Moniz Hospital’s Ambulatory Surgery Unit between the january first 2022 ant March 30th 2023. The data was analyzed using Microsoft Excel®.

Results

A total of 11 patients underwent surgery under BB. The duration of the surgical procedure was less than 60 min in 8 of the surgeries and lasted between 60-90 min in the remaining 3. No complications were registered, namely LAST or pain associated with tourniquet. Discharge time after surgery was on average 147 minutes after surgery. Only 5 patients had pain 24h after surgery, and all were able to control the pain with oral analgesics. No patient had pain 48h after surgery.

Conclusions

Intravenous regional anesthesia has a high potential to be used in an outpatient setting, as it allows adequate anesthesia for short-term surgeries and is rapidly reversed, allowing the limb to be mobilized before discharge.

Attachment

Estudo BLOQUEIOS DE BIER EM AMBULATÓRIO » Parecer da CES do CHLO.pdf