IVRA (Intravenous Regional Anesthesia): Theory, tips and tricks

In this video, we describe both practical tips and the theoretical basis for IVRA (aka "Bier block"), an excellent method of anesthetizing the upper or lower limb for short procedures.

[@aftabahmed9143]

Nicely explained

[@carlao2536]

Great video and clear explanation. Thank you.

[@regionalanesthesiology]

Thanks for watching!

[@Elneato]

I had a Bier's block fail today for Colles' fracture reduction in the emergency room. Systolic was 155mmHg (in the other arm), double tourniquet inflated to 260mmHg in sequential manner as you describe here, but after injecting 60mL of prilocaine 0.5% the arm went purple, the capillary refill was quite brisk and there was no appreciable block at all ...Not really sure if the tourniquet was wrong or he had a serious difference in blood pressures between the arms... But a hematoma block with lidocaine/adrenaline solved the problem ;)
Would you consider doing a video on hematoma blocks in future? I'm an ER doc and I'm a huge fan of hematoma blocks for reduction of distal radius fractures, and I've had success with hematoma block for reduction of ankle fractures as well.

[@hootie6787]

I'm going in for this, this week and uh, this didn't help feel better

[@tashaalbus7791]

That technique seems a bit risky for giving yourself a needle stick injury.

[@regionalanesthesiology]

It should be no more risky than performing a regular IV cannulation. Overall it's a fairly safe, effective and simple technique, especially when you've got a quick procedure that doesn't warrant a brachial plexus block. Thanks for watching!!