Intravenous Regional Sympathetic Block

What is an intravenous regional sympathetic block (Bier Block)?

A Bier block is a procedure used to treat chronic pain of the lower arm or leg. A tourniquet is placed on the arm or leg and medicine is injected into that limb. The medicine is left in place for 30 minutes before the tourniquet is let down. Your hand or foot will be numb during this procedure. This procedure is used to treat sympathetically mediated pain and can be useful in people who have Chronic Regional Pain Syndrome (CRPS or RSD).

How is a Bier Block performed?

An IV is placed in the affected limb (hand or foot.) A rubber bandage similar to an Ace wrap is used to squeeze the blood out of this limb and then a tourniquet is inflated. Numbing medicine and clonidine is then injected through the IV into this limb. It is left in place for 30 minutes and then the tourniquet is deflated.

Will I be “put out” for this procedure?

You will not be placed under general anesthesia for this procedure. If you choose, you may have intravenous sedation (twilight) to help you relax for the procedure.

What are the risks?

You may have an allergic reaction to any of the medicines that we use. After the tourniquet is released, you may have a metallic taste in your mouth or ringing in your ears. Rare side effects include seizures which would only be temporary and managed by your anesthetist. You may experience hypotension (low blood pressure) after the injection which can be treated with IV fluid or medication.