Beir block(IVRA)

What is it:

Intravenous regional anaesthesia (IVRA) is indicated for any procedure on the arm below the elbow or leg below the knee that will be completed within 40-60 minutes. Onset of anaesthesia is rapid and reasonable muscle relaxation can be obtained. Its use is limited to procedures lasting less than an hour because of increasing discomfort from the tourniquet.

Purpose:

IVRA is better for the reduction of a Colles fracture, provided there are no contra-indications to its use. The main reasons for recommendation are:-
  • IVRA provides better analgesia and therefore patient comfort
  • It produces a better anatomical restoration of the deformity.
  • There is a reduced incidence of carpal tunnel syndrome
  • Prilocaine has been shown to be safe for use in IVRA and patient safety is our utmost priority.

How is it Done:

Before beginning to perform the block, the patient's blood pressure should be measured. An intravenous cannula or butterfly needle is then inserted in a distal vein in the limb scheduled for surgery (eg. in the dorsum of the hand or foot). It is good practice to place a cannula in another limb as well in case any complications (see below) occur, which may require intravenous drug administration. The tourniquet is then applied to the upper arm or thigh. It should never be placed on the forearm or lower leg as adequate arterial compression cannot then be obtained.
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