{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T20:48:38Z","timestamp":1789937318702,"version":"4.0.1"},"reference-count":10,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T00:00:00Z","timestamp":1542758400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>Background: Bier block provides anesthesia of an entire extremity distal to the tourniquet without necessitating direct injection at the surgical site. This avoids obscuring anatomy with local anesthetic and anesthetizes a wide area, allowing for multiple procedures and incisions. We hypothesize that a low-volume Bier block with forearm tourniquet, rather than a traditional brachial tourniquet, is a safe, well-tolerated, and effective anesthesia technique. Methods: All cases in which adult patients underwent hand procedures using Bier block anesthesia by a single surgeon over a 4-year period were reviewed. Data collected included patient demographics, procedure(s) performed, complications, tourniquet time and settings, procedure and in-room time, and supplemental medications administered. Results: In all, 319 patients were included, 103 from a university hospital and 216 from an ambulatory surgery center. The most commonly performed procedures were carpal tunnel release (205 cases) and trigger digit release (83 cases). Most patients received a 125-mg dose of lidocaine for the Bier block; many also received additional sedatives. Twenty-three patients received no additional medications. No patients required conversion to general anesthesia. One complication (0.3%) occurred, with paresthesias and tinnitus that resolved without intervention. The average tourniquet time was 24 minutes (SD = 4.3 minutes). Patients were discharged at a median of 49 minutes postoperatively, and 9.1% of patients received supplemental analgesics prior to discharge. Conclusions: Regional anesthesia achieved with a forearm tourniquet and intravenous local anesthetic provides adequate pain control, permits timely discharge home, and has a low complication rate. It should be considered for use in outpatient hand procedures.<\/jats:p>","DOI":"10.1177\/1558944718812190","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T09:47:18Z","timestamp":1542793638000},"page":"353-359","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Intravenous Regional Anesthesia Using a Forearm Tourniquet: A Safe and Effective Technique for Outpatient Hand Procedures"],"prefix":"10.1177","volume":"15","author":[{"given":"Natalie","family":"Vaughn","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niraja","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Darowish","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,11,21]]},"reference":[{"key":"bibr1-1558944718812190","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2014.12.046"},{"key":"bibr2-1558944718812190","doi-asserted-by":"publisher","DOI":"10.1097\/00115550-200809000-00014"},{"key":"bibr3-1558944718812190","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2009.01.015"},{"key":"bibr4-1558944718812190","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet032"},{"key":"bibr5-1558944718812190","first-page":"109","volume":"76","author":"Singh R","year":"2010","journal-title":"Minerva Anestesiol"},{"key":"bibr6-1558944718812190","doi-asserted-by":"publisher","DOI":"10.1054\/jhsb.2002.0787"},{"key":"bibr7-1558944718812190","first-page":"23","volume":"61","author":"Ng E","year":"2006","journal-title":"Med J Malaysia"},{"key":"bibr8-1558944718812190","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/SAP.0b013e318276da4c","volume":"73","author":"Arslanian B","year":"2014","journal-title":"Ann Plast Surg"},{"key":"bibr9-1558944718812190","first-page":"401","volume":"70","author":"Aydogan N.","year":"2004","journal-title":"Acta Orthop Belg"},{"key":"bibr10-1558944718812190","doi-asserted-by":"publisher","DOI":"10.1177\/1558944716686214"}],"container-title":["HAND"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944718812190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1558944718812190","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1558944718812190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:29:45Z","timestamp":1777447785000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1558944718812190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,21]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1177\/1558944718812190"],"URL":"https:\/\/doi.org\/10.1177\/1558944718812190","relation":{},"ISSN":["1558-9447","1558-9455"],"issn-type":[{"value":"1558-9447","type":"print"},{"value":"1558-9455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,21]]}}}