Tham C H, Lim B H
Department of Plastic Surgery, Singapore General Hospital, Singapore.
J Hand Surg Br. 2000 Dec;25(6):575-7. doi: 10.1054/jhsb.2000.0423.
A prospective study was conducted to assess a modification to Bier's intravenous regional anaesthesia which introduced a third temporary distal forearm tourniquet. This confines the injected lignocaine to the hand, resulting in a higher local lignocaine concentration. Subsequent exsanguination of the limb then channels the remaining intravascular lignocaine under the distal cuff of a double tourniquet. Of the 18 patients, none experienced pain during operation and all tolerated the tourniquet without significant discomfort. Mild postoperative giddiness was noted in one patient. No other anaesthetic complications were encountered. In a subjective assessment of the bloodlessness of the operating field, two were ranked satisfactory, ten good and six excellent. None of the patients required re-exsanguination when using this technique.
开展了一项前瞻性研究，以评估对比尔静脉区域麻醉的一种改良方法，该方法引入了第三个临时的前臂远端止血带。这将注入的利多卡因限制在手部，从而使局部利多卡因浓度更高。随后对肢体进行驱血，使剩余的血管内利多卡因在双层止血带的远端袖带下方流动。18例患者中，无一例在手术过程中感到疼痛，所有患者均能耐受止血带，无明显不适。1例患者术后出现轻度头晕。未遇到其他麻醉并发症。在对手术视野无血情况的主观评估中，2例评为满意，10例评为良好，6例评为优秀。使用该技术时，无一例患者需要再次驱血。
