Venous pressures during Bier's block can exceed tourniquet occluding pressure, providing a mechanism for systemic toxicity despite an intact tourniquet.
Potential mechanism for systemic toxicity in Bier block despite intact tourniquet; hypothesis-generating and should not yet alter practice.
Venous pressures in the forearm veins during the simulated performance of intravenous regional analgesia were measured. Pressures obtained equalled or exceeded the recommended occluding pressure of the tourniquet. This finding is proposed as one of the possible reasons for the occasional observation that convulsions may occur during Bier's block despite the presence of an intact tourniquet system.
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Lawes et al. (1984) studied this question.
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