BIER oy ty Tey gwBIER BLOCK It is a type of regional anesthesia It provides anesthesia and sedation for individuals who need surgery on the lower or upper extremities It is use to the hand and foot, but in the leg the dose is twice what it was in the hand For operations to extract a stuck object, nerve operations Extraction and other operations Itis done through several tools: 1. Compression bandage 2. Two cuffs from the pressure device 3 Prilocaine 0.5% 4.Cannula number 2IMPORTANT WOTE It is strictly forbidden to open the palm before 45 minutes to prevent the medicine from returning to the heart and causing cardiac arrest Temust be opened in less than an hour to prevent the hand from dying CONTRAIMDICATIONS ‘Allergy toloalansestetic ‘Hypertension 200m He ‘Intecton inthe limb sLymphoedema + Methaemopobinaemia ‘= Moc cbesty los he cf is unretiabe on obs ats) ‘Peripheral vascular isese ‘+ Raynauels phenomenon Scleroderma sSeverehypertension Sede cell sca or trait ‘+ Uncooperativeor confused patentAPPLIED METHOD |. CANNULAS ARE INSTALLED INTHE HANDS 2. RAISE THE HAND AND TIE {T WITH A RUBBER BAND FOR A QUARTER OF ANHOUR FOR THE PURPOSE OF EMPTYING THE HAND OF BLOOD SL BEFORE OPENING THE BANDAGE, THE COMPRESSING PALMS PLACED ON THE UPPER SIDE OF THE HAND TO PREVENT BLOOD FROM RETURNING TO THE HAND 4 WEINJECT LOCAL ANESTHESIA INTO THE CANNULA, SUCH ASPRILOCAINE AT A CONCENTRATION OF 05% '. AFTER THE INJECTION, THE FIRST PALM ISEMPTIED OF AIR AND THE SECOND PALM IS INFLATED 6 WAITFOR 20 4 MINUTES AND WE BEGIN THE SURGERYAlthough peripheral nerve blocks are overall safe when performed correctly , there are rare but serious risks associated with them. bleeding, infection, damage to surrounding structures, permanent nerve injury, and intravascular uptake of local anesthetic resulting in systemic toxicityInflated Proximal Cuff Proximal Cuff Distal Cuff Inflated Proximal Cuff & limb injected with LA Both cuffs inflated & limb injected with LA Deflated Proximal Cuff inflated Distal Cuff onto anaesthetised limb