9 Intravenous Regional Block
Perspective
Intravenous (IV) regional anesthesia was introduced by Bier in 1908. As illustrated in Figure 9-1, in the initial description a surgical procedure was required to cannulate a vein, and both proximal and distal tourniquets were used to contain the local anesthetic in the venous system. After its introduction, the technique fell into disuse until the less toxic amino amides became available in the mid-20th century. This technique can be used for a variety of upper extremity operations, including both soft tissue and orthopedic procedures, primarily in the hand and forearm. The technique has also been used for foot procedures with a calf tourniquet.
