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Journal of Hand Surgery (European Volume)
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Historical Article

Comparison of Forearm and Conventional Bier’s Blocks for Manipulation and Reduction of Distal Radius Fractures

A. K. S. CHONG
D. M. K. TAN
B. S. OOI
M. MAHADEVAN
A. Y. T. LIM
B. H. LIM

From the Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore

Correspondence: Dr Alphonsus Chong, Department of Hand and Reconstructive Microsurgery, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore. Tel.: +65 6772 5549; fax: +65 6773 2558. E-mail:alfchong{at}gmail.com

Forearm-based Bier’s block has been advocated as a useful anaesthesic technique in hand surgery. However, there is limited data comparing forearm blocks with the conventional Bier’s block. We conducted a randomised controlled trial (n = 30) comparing the two techniques of anaesthesia for manipulation and reduction of closed distal radius fractures in an emergency room setting. Pain scores measured using the Visual Analogue Scale during the procedure were used as the primary outcome assessment. There was no significant difference in pain scores between the forearm and conventional Bier’s block (mean VAS 18.4 SD 22.10 versus 33.7 SD 29.6). No major complications were observed in either group. The forearm-based Bier block is an effective alternative to the conventional block.

Key Words: Bier’s block • regional anaesthesia • hand surgery • distal radius fracture

Journal of Hand Surgery (European Volume), Vol. 32, No. 1, 57-59 (2007)
DOI: 10.1016/j.jhsb.2006.10.002
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