A Bier block is a procedure used to provide pain relief in the arm or leg. Patients with chronic regional pain syndrome (CRPS) are among those who may benefit from a Bier block.

Your child should not feel any pain during this procedure, although multiple intravenous catheters will have to be placed for the procedure.

What You Should Expect

Your child should have nothing to eat or drink for eight hours prior to the procedure. Have your child wear comfortable, loose clothing on the day of the procedure. Expect to stay for several hours at the hospital.

You and your child will come to Same Day Surgery the day of the procedure. We will check you into the hospital and give your child a hospital gown to wear. Before the procedure, your doctor will:

• Review the procedure
• Answer any questions you might have about the Bier block
• Have a consent form for the procedure for you to sign

From Same Day Surgery, your child will go to the operating room. They may receive anesthesia medicine that puts them to sleep. Depending on the age of the child, the procedure may not start until your child is asleep. Some children may only require sedation.

Performing a Bier Block

Here are the steps that occur in the operating room. A Bier block usually takes about 10 minutes to perform though there will be additional time required to set up and prepare for the procedure.

• The doctor will put a cuff on the upper part of the limb.
• An IV is placed in the same limb. A second IV is placed in another extremity.
• The limb is raised in the air and then wrapped to help drain the blood out of the limb.
• After the cuff is inflated, the doctor puts numbing medicine into the IV in the limb.
• The numbing medicine is left in the limb for a specific amount of time before the cuff is deflated. The doctor will decide how long the cuff stays inflated.

Once the Bier block is done, the doctor will come out and talk with you. Your child may still be asleep at that time. After the procedure, your child will go to an area called the Post Anesthesia Care Unit (PACU). In the PACU, your child will wake up from the anesthesia or sedation. A nurse will come to the waiting area and invite you to your child’s bedside once it is safe to have visitors. The amount of time children spend in the PACU varies, but is usually about an hour.

Children usually have little or no pain when they wake up.

Your Child's Return Home

Once your child is awake and comfortable, you can go home. The arm or leg that was treated will feel numb, heavy, and may have a burning feeling. The numb feeling should not last longer than two hours. There should be little or no pain by the time they are ready to go home.

At Home Care

At home, your child may be quieter and sleepier than usual for the rest of the day. Increase activities slowly over the next few days, based on how your child feels. It is important to visit the pain clinic two weeks after the Bier block. Call 513-636-7768 to schedule your child’s visit.

Call the doctor if your child has:

• Your child has a fever above 101 degrees
• Your child has prolonged numbness in the arm or leg (longer than 24 hours)
• You have any concerns about your child’s recovery