Intravenous regional anaesthesia is used to provide limb analgesia by the infusion of local anaesthetic into the venous system. The drug is kept in the regional circulation by the action of an arterial tourniquet.
Analgesia generally commences within 5 minutes, permitting limb surgery or the manipulation of fractures. After a maximum of one-and-a-half hours, the tourniquet must be released: there is a danger of arrhythmias and fitting due to the systemic action of the drug.
Intravenous regional anaesthesia is commonly carried out on the arm - Bier's block - in the setting of the accident and emergency department. Similar blocks in the leg are far less effective.
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