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Protocols vary depending on local standard procedures and the extremity being operated on. A vast majority of practitioners begin by exsanguinating the limb as Bier did with an elastic bandage (Esmarch bandage), squeezing blood proximally toward the heart, then pneumatic tourniquets are applied to the limb and inflated 30mmHg above arterial pressure to occlude all blood vessels and then the ...
On August 16, 1898, German surgeon August Bier (1861–1949) performed surgery under spinal anesthesia in Kiel. [12] Following the publication of Bier's experiments in 1899, a controversy developed about whether Bier or Corning performed the first successful spinal anesthetic. [13] [14] There is no doubt that Corning's experiments preceded ...
In 1908, Bier pioneered the use of intravenous regional anesthesia, [2] [3] a technique which is commonly referred to as a "Bier block". [4] This technique is frequently used for operations of brief duration upon the hand, wrist, and forearm. It can also be used for operations of brief duration upon the foot, ankle, and leg. [2] [3]
The purpose of anesthesia can be distilled down to three basic goals or endpoints: [2]: 236 hypnosis (a temporary loss of consciousness and with it a loss of memory.In a pharmacological context, the word hypnosis usually has this technical meaning, in contrast to its more familiar lay or psychological meaning of an altered state of consciousness not necessarily caused by drugs—see hypnosis).
The axillary block is particularly useful in providing anesthesia and postoperative analgesia for surgery to the elbow, forearm, wrist, and hand. The axillary block is also the safest of the four main approaches to the brachial plexus, as it does not risk paresis of the phrenic nerve, nor does it have the potential to cause pneumothorax. [12]
Esmarch bandage (also known as Esmarch's bandage for surgical haemostasis or Esmarch's tourniquet) in its modern form is a narrow (5 to 10 cm (2.0 to 3.9 in) wide) soft rubber bandage that is used to expel venous blood from a limb (exsanguinate) that has had its arterial supply cut off by a tourniquet.
Spinal anaesthesia (or spinal anesthesia), also called spinal block, subarachnoid block, intradural block and intrathecal block, [1] is a form of neuraxial regional anaesthesia involving the injection of a local anaesthetic or opioid into the subarachnoid space, generally through a fine needle, usually 9 cm (3.5 in) long.
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