Intravenous regional anaesthesia for foot surgery

Intravenous regional anaesthesia, confined to the distal lower limb and using bupivacaine 0.25%, was studied in 12 patients undergoing orthopaedic procedures to the feet. The technique was well accepted by both surgeons and patients and was free from serious toxicity. Bupivacaine was demonstrated in the systemic venous circulation in every case prior to surgery, whilst the tourniquet remained inflated. The plasma bupivacaine levels were less than that associated with toxicity, except in one case exhibiting signs of minor toxicity (bupivacaine plasma level 1.99 μg/ml‐1). Reasons for the leak in spite of a well‐conducted technique are discussed.

[1]  P. Robbins,et al.  Venous Pressures During Simulated Bier??s Block , 1984 .

[2]  I. D. Hall,et al.  Intravenous regional analgesia , 1984, Anaesthesia.

[3]  A. Black,et al.  Venous pressure and arm volume changes during simulated Bier's block , 1984, Anaesthesia.

[4]  F. Reynolds.  Bupivacaine and intravenous regional anaesthesia , 1984, Anaesthesia.

[5]  P. Robbins,et al.  Venous pressures during simulated Bier's block , 1984, Anaesthesia.

[6]  I. D. Hall,et al.  Bupivacaine leak past inflated tourniquets during intravenous regional analgesia , 1983, Anaesthesia.

[7]  A. Green,et al.  Intravenous regional anesthesia. , 1983, Journal of the American Podiatry Association.

[8]  E. Kalso,et al.  Acute bupivacaine toxicity as a result of venous leakage under the tourniquet cuff during a Bier block. , 1983, Anesthesiology.

[9]  M. Heath.  Deaths after intravenous regional anaesthesia. , 1982, British medical journal.

[10]  T. Stevenson,et al.  Tourniquet failure and arterial calcification , 1981, Anaesthesia.

[11]  D. Scott,et al.  Intravenous regional analgesia using bupivacaine , 1979, Anaesthesia.

[12]  L. Mather,et al.  Bupivacaine (Marcaine®): An Evaluation of its Tissue and Systemic Toxicity in Humans , 1977, Acta anaesthesiologica Scandinavica.

[13]  L. Mather,et al.  Arterial and venous plasma levels of bupivacaine following peripheral nerve blocks. , 1976 .

[14]  R. Ware.  Intravenous regional analgesia using bupivacaine , 1975, Anaesthesia.

[15]  J. Lawton,et al.  Intravenous regional anesthesia in the lower leg and foot. , 1974, Journal of the American Podiatry Association.

[16]  G. Tucker,et al.  Meperidine and other basic drugs: general method for their determination in plasma. , 1974, Journal of pharmaceutical sciences.

[17]  Thorn-Alquist Am.  INTRAVENOUS REGIONAL ANAESTHESIA. A SEVEN-YEAR SURVEY , 1972 .

[18]  A. Thorn‐Alquist.  INTRAVENOUS REGIONAL ANAESTHESIA , 1971 .

[19]  P. de Temmerman,et al.  [Intravenous regional anesthesia]. , 1967, Acta anaesthesiologica Belgica.