For historical reasons we still starve our Biers blocks (6 hours) and have
to have a 2nd doctor. I agree that it is a waste of time, but old habits
die hard!
Simon Carley
Anaesthetics / Intensive Care
Stepping Hill Hospital
Stockport
England
[log in to unmask]
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> From: Meek, Steve <[log in to unmask]>
> To: [log in to unmask]; [log in to unmask]
> Subject: RE:Biers Block
> Date: 15 December 1998 14:55
>
> Rowley, I must speak up for the Biers block.
> The requirement for a second doctor, like starvation prior to Biers, was
a
> recommendation made years ago, by the Royal College of Anaesthetists, I
> believe, after marcain induced deaths, and that document is long
obsolete.
> Since the change to prilocaine (3mg/kg), no serious adverse reactions
have
> been reported in over 30,000 Biers blocks. I have personally seen the
cuff
> deflate twice, once immediately after injection...I wet myself but the
> patients remained asymptomatic.
> A paper in the J Trauma a few years ago showed injection into the ACF
veins
> was safe, a development which helps somewhat as often the hand and wrist
are
> swollen.
>
> Biers is superior to haematoma block in terms of analgesia and anatomical
> reduction in Colles fracture and in my opinion is safe for one trained
> doctor to perform - and it is easier to learn to do properly than a
> haematoma block.
>
> Steve Meek
> Emergency Medicine
> RUH Bath
> > ----------
> > From: [log in to unmask][SMTP:[log in to unmask]]
> > Sent: 11 December 1998 05:12
> > To: [log in to unmask]
> > Cc: [log in to unmask]
> > Subject: Re: Hugh Owen Thomas
> >
> > In-Reply-To: <[log in to unmask]>
> > Bier's block is excellent, but does require a second doctor to be
> > available throughout.
> >
> > /Rowley./
> >
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