I'd agree that the cuff can be let down at 15 mins (see below), however I
say 20 mins to the juniors in order to give a margin of error.
Ray McGlone
A&E Lancaster
Authors
Cox P.
Institution
Department of Anaesthesia, Motala Hospital, Sweden.
Title
Intravenous regional analgesia--a new modification.
Source
Acta Anaesthesiologica Scandinavica. 33(4):336-8, 1989 May.
Abstract
A modification of the standard intravenous regional analgesia technique is
described whereby excess local anaesthetic solution is removed from the
veins of the isolated arm once analgesia has been established. This simple
procedure was shown to reduce the incidence of oozing at the site of
operation without affecting the quality of analgesia. Measurement of the
quantity of local anaesthetic agent removed from the isolated arm 15 min
after injection revealed that the amounts removed were small, indicating
rapid uptake and binding in the tissues. This would imply that removal of
excess local anaesthetic agent from the isolated arm after 15 min does not
confer added safety as regards reducing the risk of leakage of agent into
the general circulation in the event of cuff failure.
----- Original Message -----
From: "Adrian Fogarty" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, October 02, 2002 10:10 AM
Subject: Re: Bier's block versus haematoma
> ----- Original Message -----
> From: "Andrew Webster"
> > It doesn't take long to consent the patient draw up prilocaine. 10 mins
to
> > wait for sufficent anaesthesia. Manipulate. Further 10 minutes before
cuff
> > can be deflated. Whizz round to xray. Due to superb anaesthetic....often
> > no need to manipulate again.
>
> We don't formally consent as it is an awake procedure. Also try deflating
at
> 15 minutes from injection; there are no problems. And I agree, the only
ones
> that I've seen that needed remanipulating were done in theatre with
imaging
> and k-wires! I see these "failures" less now, as I can usually spot the
> difficult ones before I attempt them and so send them straight to orthos
in
> the first place.
>
> Adrian Fogarty
>
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