Intravenous regional anesthesia--'Bier block'.

The Bier block is ideally suited for management of many types of trauma to an extremity. Blood is removed from an injured extremity by elevation and wrapping, and then a pneumatic tourniquet is applied proximal to the site of injury. Lidocaine is then injected into a vein distal to the tourniquet. The tourniquet prevents entry of the lidocaine into the general circulation while anesthesia is obtained in the extremity; it also provides a bloodless surgical field.