An uncommon approach of Bier block for tibial surgery; A case report

This case report presents the first documented use of a Bier block (intravenous regional anesthesia) for lower limb surgery in Pakistan, detailing its application in a 39-year-old male undergoing the removal of a dynamic compression plate from his left tibia. The procedure utilized a total of 50 mL of lignocaine, achieving effective analgesia throughout the surgery, with the patient reporting minimal discomfort. This case underscores the efficacy and safety of the Bier block as a viable alternative to general anesthesia for orthopedic procedures, addressing a significant gap in the literature regarding its use in lower limb surgeries. The successful outcome highlights the potential for improved postoperative pain management and sets a precedent for further research and clinical practice in this area. Abbreviations: IVRA: intravenous regional anesthesia, MET score: Metabolic Equivalent of Task score, PACU: Post-Anesthesia Care Unit, VAS: Visual Analog Scale Keywords: Lower Extremity; Orthopedic Procedures; Tourniquets; Compartment Syndromes; IVRA Citation: Ali L, Ali U, Qureshi AA, Nasir S, Fatima N. An uncommon approach of Bier block for tibial surgery; A case report. Anaesth. pain intensive care 2025;29(3):695-698. DOI: 10.35975/apic.v29i3.2780 Received: October 23, 2024; Revised: February 05, 2025; Accepted: March 23, 2025