بلوک وریدی اندام تحتانی با لیدوکائین و سولفات منیزیم در بیمار دیابتیک با مشکلات قلبی کاندید عمل جراحی آمپوتاسیون زیر زانو (BKA)

Bier block anesthesia is an intravenous regional anesthesia technique in which an extremity is made numb for surgery by injecting a local anesthetic solution into a vein after the blood has been squeezed out of the extremity and a tourniquet has been placed on it. The tourniquet prevents the local anesthetic from leaving the extremity and blood from entering it, giving the patient a numb (anesthetic) extremity and the surgeon a bloodless field to work in. The technique is named for August Bier. The advantages of the technique is that it is simple to perform, and provides a bloodless field that is easy to work in and minimizes blood loss. The disadvantages are that there is a practical time limit on its use of about 1 hour due to tolerance of the awake patient for the pain of the tourniquet and 2 hours due to the maximum time blood flow can be restricted to the extremity without anoxic tissue damage. In this case we performed bier block in a high risk diabetic patient for below knee amputation. We added mg sulfate as an adjuvant drug in order to improve block quality and to prolong patient analgesia.