Journal of Clinical Anesthesia
Volume 21, Issue 8 , Pages 585-594 , December 2009

Adverse events associated with intravenous regional anesthesia (Bier block): a systematic review of complications

  • Joanne Guay, MD, FRCPC (Clinical Associate Professor)

      Affiliations

    • Corresponding Author InformationTel.: +1 514 252 3426; fax: +1 514 252 3542.

Received 7 June 2008 ,Revised 2 January 2009 ,Accepted 20 January 2009.

References 

  1. Kendall JM, Allen PE, McCabe SE. A tide of change in the management of an old fracture?. J Accid Emerg Med. 1995;12:187–188
  2. Handoll HH, Madhok R, Dodds C. Anaesthesia for treating distal radial fracture in adults. Cochrane Database Syst Rev. 2002;(3):CD003320
  3. Chan VW, Peng PW, Kaszas Z, et al. A comparative study of general anesthesia, intravenous regional anesthesia, and axillary block for outpatient hand surgery: clinical outcome and cost analysis. Anesth Analg. 2001;93:1181–1184
  4. Bier A. Uber einen neuen weg local-anasthesie an den gliedmasse zu erzeugen. Arc Klin Chir. 1908;86:1007–1016
  5. Reynolds F. Bupivacaine and intravenous regional anaesthesia. Anaesthesia. 1984;39:105–107
  6. Lee LA, Posner KL, Domino KB, Caplan RA, Cheney FW. Injuries associated with regional anesthesia in the 1980s and 1990s: a closed claims analysis. Anesthesiology. 2004;101:143–152
  7. Henderson AM. Adverse reaction to bupivacaine: complication of intravenous regional analgesia. Br Med J. 1980;281:1043–1044
  8. Machado HS, Bastos RS. Inadequate tourniquet inflation associated with a case of prilocaine toxicity. Eur J Anaesthesiol. 1998;15:234–236
  9. Magora F, Stern L, Zylber-Katz E, Olshwang D, Donchin Y, Magora A. Prolonged effect of bupivacaine hydrochloride after cuff release in i.v. regional anaesthesia. Br J Anaesth. 1980;52:1131–1136
  10. Cherng CH, Wong CS, Ho ST. Acute aphesia following tourniquet release in intravenous regional anesthesia with 0.75% lidocaine. Reg Anesth Pain Med. 2000;25:211–212
  11. Sawyer RJ, von Schroeder H. Temporary bilateral blindness after acute lidocaine toxicity. Anesth Analg. 2002;95:224–226
  12. Mark LC, Marx GF, Arkins RE, et al. Clinical anesthesia conference. Complications of intravenous regional anesthesia. N Y State J Med. 1966;66:1344–1345
  13. Ahmed SU, Vallejo R, Hord ED. Seizures after a Bier block with clonidine and lidocaine. Anesth Analg. 2004;99:593–594
  14. Dawkins OS, Fleming SA, Russell ES, Adams AK, Hooper RL, Odiakosa AO. Intravenous lignocaine for surgical analgesia in the extremity. West Afr Med J. 1965;14:35–40
  15. Van Niekerk JP, Tonkin PA. Intravenous regional analgesia. An assessment of the procedure for the surgery of hand infections. S Afr Med J. 1966;40:165–169
  16. Davies JA, Gill SS, Weber JC. Intravenous regional analgesia using bupivacaine. Anaesthesia. 1981;36:331
  17. Davies JA, Hall ID, Wilkey AD, Smith JE, Walford AJ, Kale VR. Intravenous regional analgesia. The danger of the congested arm and the value of occlusion pressure. Anaesthesia. 1983;39:416–421
  18. Emmett C. More trouble with Bier's block. Anaesthesia. 1983;38:390
  19. El-Hassan KM, Hutton P, Black AM. Venous pressure and arm volume changes during simulated Bier's block. Anaesthesia. 1984;39:229–235
  20. Kern C, Gamulin Z. Generalised convulsions after intravenous regional anaesthesia with prilocaine. Anaesthesia. 1994;49:642–643
  21. Hanton RJ, Punchihewa VG. Intravenous regional analgesia using bupivacaine. Anaesthesia. 1982;37:350–351
  22. Cox JM. Intravenous regional anaesthesia. Can Anaesth Soc J. 1964;11:503–508
  23. Finsterbush A, Stein H, Robin GC, Geller R, Cotev S. Recent experiences with intravenous regional anesthesia in limbs. J Trauma. 1972;12:81–84
  24. Henderson A, Sujitkumar P. Successful resuscitation after cardiac arrest following i.v. regional anaesthesia (IVRA). Br J Anaesth. 1986;58:362
  25. Rosenberg PH, Kalso EA, Tuominen MK, Linden HB. Acute bupivacaine toxicity as a result of venous leakage under the tourniquet cuff during a Bier block. Anesthesiology. 1983;58:95–98
  26. Christie JL. Fatal consequences of local anesthesia: report of five cases and a review of the literature. J Forensic Sci. 1976;21:671–679
  27. Kennedy BR, Duthie AM, Parbrook GD, Carr TL. Intravenous regional analgesia: an appraisal. Br Med J. 1965;1:954–957
  28. Kew MC, Lowe JP. The cardiovascular complications of intravenous regional anaesthesia. Br J Surg. 1971;58:179–182
  29. Albright GA. Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology. 1979;51:285–287
  30. Heath ML. Deaths after intravenous regional anaesthesia. Br Med J (Clin Res Ed). 1982;285:913–914
  31. Heath ML. Bupivicaine toxicity and Bier blocks. Anesthesiology. 1983;59:481
  32. Larsen UT, Hommelgaard P. Pneumatic tourniquet paralysis following intravenous regional analgesia. Anaesthesia. 1987;42:526–528
  33. McGlone R, Heyes F, Harris P. The use of muscle relaxant to supplement local anaesthetics for Bier's blocks. Arch Emerg Med. 1988;5:79–85
  34. Hastings H, Misamore G. Compartment syndrome resulting from intravenous regional anesthesia. J Hand Surg [Am]. 1987;12:559–562
  35. Quigley JT, Popich GA, Lanz UB. Compartment syndrome of the forearm and hand: a case report. Clin Orthop Relat Res. 1981;161:247–251
  36. Mabee JR, Bostwick TL, Burke MK. Iatrogenic compartment syndrome from hypertonic saline injection in Bier block. J Emerg Med. 1994;12:473–476
  37. Ananthanarayan C, Castro C, McKee N, Sakotic G. Compartment syndrome following intravenous regional anesthesia. Can J Anaesth. 2000;47:1094–1098
  38. Luce EA, Mangubat E. Loss of hand and forearm following Bier block: a case report. J Hand Surg [Am]. 1983;8:280–283
  39. Ball CM. Failed intravenous arm block or diagnostic test?. Anaesth Intensive Care. 1985;13:433–434
  40. Maletis GB, Watson RC, Scott S. Compartment syndrome. A complication of intravenous regional anesthesia in the reduction of lower leg shaft fractures. Orthopedics. 1989;12:841–846
  41. Ansari MM, Abraham A. Unusual discoloration of forearm with Bier's block using 0.5% lidocaine. Anesth Analg. 2005;100:1866–1867
  42. Burlingham A. Potentially dangerous reaction to intravenous regional anaesthesia using bupivacaine. Anaesthesia Points West. 1980;13:20–21
  43. Ruiz K, Stevens JD, Train JJ, Watkins J. Anaphylactoid reactions to prilocaine. Anaesthesia. 1987;42:1078–1080
  44. Ogden PN. Failure of intravenous regional analgesia using a double cuff tourniquet. Anaesthesia. 1984;39:456–459
  45. Harris WH. Choice of anesthetic agents for intravenous regional anesthesia. Acta Anaesthesiol Scand Suppl. 1969;36:47–52
  46. Monty CP, Deller CR. Experiences with intravenous regional anesthesia. Proc R Soc Med. 1965;58:338–340
  47. Pitkänen M, Kyttä J, Rosenberg PH. Comparison of 2-chloroprocaine and prilocaine for intravenous regional anaesthesia of the arm: a clinical study. Anaesthesia. 1993;48:1091–1093
  48. Auroy Y, Narchi P, Messiah A, Litt L, Rouvier B, Samii K. Serious complications related to regional anesthesia: results of a prospective survey in France. Anesthesiology. 1997;87:479–486
  49. Bratt HD, Eyres RL, Cole WG. Randomized double-blind trial of low- and moderate-dose lidocaine regional anesthesia for forearm fractures in childhood. J Pediatr Orthop. 1996;16:660–663
  50. Lowen R, Taylor J. Bier's block–the experience of Australian emergency departments. Med J Aust. 1994;160:108–111
  51. Guay J. Methemoglobinemia related to local anesthetics: a summary of 242 episodes. Anesth Analg. 2009;108:837–845
  52. Cladis FP, Litman RS. Transient cardiovascular toxicity with unintentional intravascular injection of 3% 2-chloroprocaine in a 2-month-old infant. Anesthesiology. 2004;100:181–183
  53. Marsch SC, Sluga M, Studer W, Barandun J, Scharplatz D. Ummenhofer W. 0.5% versus 1.0% 2-chloroprocaine for intravenous regional anesthesia: a prospective, randomized, double-blind trial. Anesth Analg. 2004;98:1789–1793
  54. Smith AR, Hur D, Resano F. Grand mal seizures after 2-chloroprocaine epidural anesthesia in a patient with plasma cholinesterase deficiency. Anesth Analg. 1987;66:677–678
  55. Olney BW, Lugg PC, Turner PL, Eyres RL, Cole WG. Outpatient treatment of upper extremity injuries in childhood using intravenous regional anaesthesia. J Pediatr Orthop. 1988;8:576–579
  56. Bier A. On local anaesthesia with special reference to vein anaesthesia. Edinburgh Medical J. 1910;2:103–123
  57. Sukhani R, Garcia CJ, Munhall RJ, Winnie AP, Rodvold KA. Lidocaine disposition following intravenous regional anesthesia with different tourniquet deflation technics. Anesth Analg. 1989;68:633–637
  58. Tucker GT, Boas RA. Pharmacokinetic aspects of intravenous regional anesthesia. Anesthesiology. 1971;34:538–549
  59. Simon MA, Gielen MJ, Vree TB, Booij LH. Disposition of lignocaine for intravenous regional anaesthesia during day-case surgery. Eur J Anaesthesiol. 1998;15:32–37
  60. Horlocker TT, Hebl JR, Gali B, et al. Anesthetic, patient, and surgical risk factors for neurologic complications after prolonged total tourniquet time during total knee arthroplasty. Anesth Analg. 2006;102:950–955
  61. Fanelli G, Casati A, Garancini P, Torri G. Nerve stimulator and multiple injection technique for upper and lower limb blockade: failure rate, patient acceptance, and neurologic complications. Study Group on Regional Anesthesia. Anesth Analg. 1999;88:847–852
  62. Brown EM. Continuous intravenous regional anesthesia. Acta Anaesthesiol Scand Suppl. 1969;36:39–45
  63. Cooney WP, Dobyns JH, Linscheid RL. Complications of Colles' fractures. J Bone Joint Surg Am. 1980;62:613–619
  64. Pitkänen MT, Xu M, Haasio J, Rosenberg PH. Comparison of 0.5% articaine and 0.5% prilocaine in intravenous regional anesthesia of the arm: a cross-over study in volunteers. Reg Anesth Pain Med. 1999;24:131–135
  65. Kajimoto Y, Rosenberg ME, Kyttä J, et al. Anaphylactoid skin reactions after intravenous regional anaesthesia using 0.5% prilocaine with or without preservative–a double-blind study. Acta Anaesthesiol Scand. 1995;39:782–784
  66. Palas TA, Gerber HR. Intravenous regional anesthesia for operations in the lower limb: effect of two different concentrations of chloroprocaine. Reg Anesth. 1982;7:29–32

 Presented at the “XXVIII ESRA Annual Congress" Salzburg, Austria, September 9-12, 2009.

PII: S0952-8180(09)00282-7

doi: 10.1016/j.jclinane.2009.01.015

Journal of Clinical Anesthesia
Volume 21, Issue 8 , Pages 585-594 , December 2009

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