Bier Block

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We did a Bier Block yesterday. My new resident was very excited about it... I don't know if he's just an enthusiastic person or if the procedure was all that interesting. I guess we don't do that many of them, plus he's kind of new. Actually it's probably him... he IS very enthusiastic.

For those of you not familiar with the Bier Block it's named after Karl August Bier... some German guy who invented the technique in 1908. It's also called an intravenous regional anesthetic. It's useful only for surgeries on the extremities. Basically you put a pressure cuff on the arm, use a rubber bandage to squeeze out all the blood out of the arm. Then you inflate the cuff and inject local anesthetic into the arm (through an IV you've placed earlier in the hand) The arm stays numb as long as the cuff is holding the local in the arm. This works because in general nerves travel along with blood vessels in most of the body. So if you fill the vessels with local anesthetic, you also anesthetize the nerves.

Anyway now if I can just get that resident to stop calling me "Sir" we'll be in good shape.