Mini-dose Bier block intravenous regional anesthesia in the emergency department treatment of pediatric upper-extremity injuries.
The safety and effectiveness of the "mini-dose" 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 90% 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.
Bolte
R G
RG
University of Utah Department of Pediatrics, Salt Lake City.
Stevens
P M
PM
Scott
S M
SM
Schunk
J E
JE
D000293:Adolescent; D000765:Anesthesia, Conduction / Q000379:methods; D001134:Arm Injuries / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies