Bier block?
 

My dr said there's no point in doing more symoathetic blocks because I've had minimal relief. She wants to try a bier block. Anyone have experience with these?

On a side note i told the pain dr that my ot thinks I have an injury to my scaphoid ligament and asked if she got the chart notes requesting an Mri. She pretty much said that she and the hand specialist knew what they were seeing and a mri would be a waste of time?? I got frustrated and little tears came to my eyes and I said that I really wasn't content with an rsd diagnosis cause I don't want to think I have some forever thing (she just got done telling me there was little more they could do) when there is a question about an injury and my bone scan disnt show soft tissue so how could they know?

So she said she would read the notes and think on it. But we needed to do the bier block first.
Just wanted to hear some experiences of what this is like. Kind of scares me as I've had a interscalene block get into my blood stream and it was a horrible experience. And this is intentionally injecting anesthetic into my blood stream? Can they be sure the tournicate is efficient in preventing that?

Sorry I don't know but I too am curious for the answer.

What is in an inter scalene and bier block? How did the inter scalene get into ur bloodstream?

hi jenn. i'm sorry but i've never heard of a bier block. i've heard of sympathetic nerve blocks though. i had eight of them and they helped a little but not much. but everyone's different. i hope that you feel some pain relief soon. soft hugs.

An interscalene block is done into the never to your arm and shoulder and it's done near your colar bone. I had it done before having shoulder surgery and it deadens your arm so after surgery you have no pain but can't feel your arm. They missed the nerve and injected it into my blood stream. It made my heart tachycardic and they had to give me meds to slow my heart.

A bier block is done by draining an extremity of blood flow and injecting something like lidocaine and other meds intervieniously into that area. Its said to calm the nerve. From what I read they do the tournicate to keep the anesthetic from flowing into the rest of your body and to keep the blood flow from the area they are injecting.

Hi Jennijojo,

I am just in from a late flight so will keep it short.

IVRSB - IV regional sympathetic blockade is stated in the new revision of the Dutch Protocol for CRPS treatment as "having no place in the treatment of CRPS 1"

I don't recall seeing it really mentioned anywhere as a treatment of choice, some of the studies indicate no benefit. It sounds horribly unpleasant.

Bier developed this type of anesthesia in 1908. I am hoping we made some progress since then. There's ketamine to try or Calmare or the neridronate trial. Stanford just started a trial on LDN. You aren't out of options.

IMHO, it may be time to consider other doctors if the ones you have can't come up with anything better than this and telling you there's no point in imaging. Even if all it does is put your mind at ease over your diagnosis I think that has value. Stick to your guns girl, it ain't over yet! :cool:

Songbird,

I came here today to say exactly what you said
. I too have been having an increase in pain and total frustration with all that comes with it! I have been wondering why I bother continuing to choose to live this way. I always thought life was about having a family, teaching your children to be great and kind, traveling and learning about the world ....

But I will never have any of those things! I worked hard to get through nursing with a 3.8. I went to work as a cardiac nurse... Things were coming together. I had a five year plan. If finish school, try to have a baby ( at 40+)...and knew o could finally afford to adopt if I needed to... Buy my first home... But I fractured my foot at work and since then life has come crashing down around me. I will never experienced all the things I always thought made the struggles of life worth it.

I just don't know how or why I choose to continue to live in this pain and everything that comes with it.

I'm sorry I don't have much positive to say, except... You do have your daughter and it is important to be strong for her.

Velkyn,

I am a nurse too and was also hurt at work. RSD is a horrible condition, but Workman's Comp is living hell. I feel for you as my five year plan was crushed too.

As far as a Bier block, I believe they usually use a blood pressure cuff as a tourniquet. I haven't read anything supporting the use of a bier block to treat CRPS, but putting a tourniquet on a CRPS limb does not sound like a good idea.

I encourage you to keep searching for a good PM doc. I'm on my 4th one and finally found someone who really knows CRPS and can think outside of the box. I have done several brachial plexus blocks and they really have helped.

Hi,
I've had RSD since I was 16, so for 13 years now. Bier blocks were one of the first nerve block treatments my anesthesiologist started with. I have it in my right limbs. It looks as though someone above has explained the method. We used a triple valve tourniquet so that the blood is slowly released back into the limb. It must be mixed back in with the medication cocktail slowly because there is a risk of seizure. I used to have these weekly. The first one have me near complete pain relief for 2 hours, and each one gave me a little more. I think the longest I was pain free was 11 hours, and that was the 17th block within a few months but we had to stop because I was only 16 and the doctors said I had reached my limit for how many times I could be put under general anesthesia within a year without causing brain damage.
The nerve blocks I do now are better because I am awake (more uncomfortable) and though I don't get complete pain relief they last much longer and I can have them without the stress of being put under.
I hope that helps!


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Have you discussed trying a brachial plexus block instead of Bier block? You don't need to be under anesthesia for a brachial plexus block, and they're not really painful to have (very quick).

I have had more than 10 stellate ganglion blocks. While those were helpful, once I switched PMs and he tried a series of brachial plexus blocks my pain decreased dramatically. I was able to go off of all of my long acting opiods and now just use short acting when needed.