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lüll Safety and effectiveness of intravenous regional anesthesia (Bier block) for outpatient management of forearm trauma Mohr BCJEM 2006[Jul]; 8 (4): 247-50OBJECTIVE: To assess the safety and effectiveness of intravenous regional anesthesia (Bier block) in the management of forearm injuries (i.e., forearm, wrist or hand) by primary care physicians at a diagnostic and treatment facility. METHODS: A retrospective review was conducted of all patients at a single centre who underwent a Bier block for forearm injuries between September 2000 and March 2005. RESULTS: 1816 Bier blocks were performed on 1804 patients (64% male) during the study period. Patient age ranged from 4-70 (mean 25) years. Wrist fractures requiring reduction were the most common diagnosis. Adverse events were recorded in 9 cases (0.50%, 95% confidence interval 0.23%-0.94%): 1 case of medication error (0.06%); 3 of improper cuff inflation (0.17%); and 5 of inadequate analgesia (0.28%). None of the adverse events resulted in failure to complete the procedure or in serious morbidity or mortality. CONCLUSION: Bier block anesthesia is a safe, effective and reliable technique in an outpatient primary care setting. This technique is a useful modality for physicians who manage acute upper-extremity injuries.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Ambulatory Care Facilities[MESH]|Anesthetics, Local/therapeutic use[MESH]|Arm Injuries/*therapy[MESH]|Child[MESH]|Child, Preschool[MESH]|Female[MESH]|Hand Injuries/*therapy[MESH]|Humans[MESH]|Lidocaine/therapeutic use[MESH]|Male[MESH]|Middle Aged[MESH]|Nerve Block/adverse effects/*methods[MESH]|Primary Health Care[MESH]|Retrospective Studies[MESH] |