Hannington-Kiff J G
Department of Anaesthesia, Frimley Park Hospital, Surrey.
J R Soc Med. 1990 Mar;83(3):155-8. doi: 10.1177/014107689008300309.
Bier introduced his intravenous technique of local anaesthesia to facilitate palliative surgery on the elbow or knee. He cannulated a suitably large vein in the vicinity of the joint to inject procaine after first isolating the operating site with a proximal and a distal tourniquet. This extra containment of the local anaesthetic solution made it feasible to flush out any unfixed drug with saline before release of the main tourniquet, an advantage which has been lost in the currently fashionable technique of intravenous regional anaesthesia (IVRA) involving a single tourniquet above the elbow or knee and a fine butterfly needle in a vein on the dorsum of the hand or foot. A modern version of Bier's original method is described, conveniently called an intercuff block (ICB), which reintroduces the possibility of effective flushing, offers better operating conditions and engenders new ideas for further study.
比尔介绍了他的局部麻醉静脉注射技术，以方便对肘部或膝部进行姑息性手术。他在关节附近插入一根足够大的静脉，先在近端和远端使用止血带隔离手术部位，然后注入普鲁卡因。这种对局部麻醉溶液的额外限制使得在松开主止血带之前用盐水冲洗掉任何未固定的药物成为可能，而这一优势在当前流行的静脉区域麻醉（IVRA）技术中已不复存在，该技术在肘部或膝部上方使用单个止血带，并在手背或脚背的静脉中使用细蝶形针。文中描述了比尔原始方法的现代版本，方便地称为袖带间阻滞（ICB），它重新引入了有效冲洗的可能性，提供了更好的手术条件，并为进一步研究带来了新的思路。
