Abstract
Our experience with intravenous regional anaesthesia (IVRA) in 1,906 patients over a period of 20 years has confirmed that this technique is safe and effective. IVRA may be used to provide anaesthesia for surgery involving both the upper and lower extremities. The need for supplemental medication is ordinarily minimal, so the technique is particularly suitable for short procedures in an ambulatory surgery centre. Yet, prolonged surgery may be performed using a “continuous technique.” Although various local anaesthetic agents may be used to induce IVRA no drug has been demonstrated to be superior to lidocaine. The major cause of failure of the technique or serious adverse effects is technical error. A specific protocol for avoiding technical error is presented. Significantly, over a period of 20 years, there has not been any mortality or major morbidity. The incidence of adverse reactions was 1.6 per cent and consisted of minor events such as transient dizziness, tinnitus or mild bradycardia.
Résumé
En 20 ans, nous avons éprouvé l’efficacité et la sûreté de l’anesthésie intraveineuse régionale (IVRA) auprès de 1906 patients. Cette technique, applicable aux membres supérieurs et inférieurs, est particulièrement appropriée aux interventions de courte duree en externe et elle ne nécessite alors que tres peu d’adjuvants médicamenteux. Pour les chirurgies prolongies, il existe une technique iquivalente dite“continue”. line variété d’anesthésiques locaux a été utilisée, sans toutefois détrôner la lidocaïne. La plupart des echecs de l’IVRA de même que ses complications sérieuses sont imputables à une ou des erreurs techniques et nous vous présentons un protocole détaillé pour éviter de tels problèmes. Nous n’avons noté en 20 ans, aucun dices ni complications importantes autres que des étourdissements passagers, du tinnitus ou des bradycardies bénignes.
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Brown, E.M., McGriff, J.T. & Malinowski, R.W. Intravenous regional anaesthesia (Bier block): review of 20 years’ experience. Can J Anaesth 36, 307–310 (1989). https://doi.org/10.1007/BF03010770
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DOI: https://doi.org/10.1007/BF03010770