Most common local anaesthetic used for intravenous regional anesthesia (Bier block).

Lidocaine is the most - frequently selected amide local anesthetic for producing this type of regional anesthesia. Lidocaine has been the drug used most frequently for intravenous regional anesthesia. Prilocaine, mepivacaine, chloroprocaine, procaine and etidocaine have also been used successfully. Intravenous regional anesthesia or Bier's block involves the intravenous administration of a local anesthetic into a tourniquet- occluded limb. It is used to provide anesthesia for sho surgical procedures (<90 minutes) on the limbs. Note : Bupivacaine and its congeners is not used for Biers block. It is the most cardiotoxic local anesthetic. Accidental early deflation of the tourniquet can lead to massive systemic doses of bupivacaine resulting in cardiac arrhythmias and cardiovascular collapse.