Mini-Dose Bier Block Intravenous Regional Anesthesia in the Emergency Department Treatment of Pediatric Upper-Extremity Injuries

摘要

Summarycolon;The safety and effectiveness of the ldquo;minidoserdquo; Bier block, a technique of i.v. regional anesthesia using low-dose lidocaine (1.5 mg/kg) without routine premedication, was evaluated in the emergency department treatment of pediatric upper-extremity fractures and dislocations. We prospectively studied 69 patients, aged from 2 to 16 years, treated at a pediatric primary care/ referral-based emergency department. Good to excellent anesthesia was achieved during closed reduction in 90percnt; of the cases. All patients achieved an acceptable reduction, as demonstrated by follow-up radiographs. None required further treatment of the injury under general anesthesia. No significant complications were noted. We conclude that the mini-dose Bier block provides safe, reliable, and cost-effective anesthesia for the outpatient reduction of pediatric upper-extremity injuries.