Gavriely N, Kotsirakis A, August 2012.
Hand and wrist procedures range in various lengths of time and are performed under bleeding-free conditions achieved by some sort of exsanguination and tourniquet. The purpose of this paper is to describe regional and local anesthesia options facilitated by the use of forearm tourniquet, in particular the forearm sterile elastic exsanguination tourniquet (FA-SET). The paper will focus on two main strategies: (i) Local incision site infiltration while the FA-SET is tolerated by the patient without or with additional topical anesthesia at the site of the tourniquet; and (ii) Intravenous regional anesthesia (IVRA – Bier Block) performed with the FA-SET in place. The conclusion from our experience is that the use of the FA-SET for IVRA is superior and safer over the traditional methods.