Introduction to Regional Intravenous Anaesthesia
Regional intravenous anaesthesia (RIVA) is a specialised technique used to numb a limb for surgical procedures. By injecting a local anaesthetic into a vein below a tourniquet, doctors can achieve targeted pain relief without affecting the entire body. This method is particularly useful for hand and wrist surgeries, where precision is crucial.
Also known as Bier’s block, this approach minimises systemic side effects, making it a preferred choice for short procedures. However, proper training is essential to ensure safety and effectiveness.
How Regional Intravenous Anaesthesia Works
The Role of the Tourniquet
The tourniquet is the most critical component in RIVA. It prevents the anaesthetic from spreading into the bloodstream, reducing the risk of heart and lung complications. Many experts recommend using two tourniquets side by side as a backup in case one fails.
Choosing the Right Anaesthetic Agent
A fast-acting local anaesthetic like prilocaine is commonly used. Its effects wear off within 30–40 minutes, allowing the tourniquet to be safely removed after the procedure. This short duration makes it ideal for minor surgeries.
Application in Limb Procedures
While RIVA can be used on any limb, it is most effective for hand and wrist surgeries. The tourniquet is applied to the upper arm, ensuring the anaesthetic stays localised.
Benefits of Regional Intravenous Anaesthesia
- Targeted pain relief without affecting the whole body
- Quick recovery compared to general anaesthesia
- Lower risk of systemic complications
- Ideal for short procedures (under 40 minutes)
Safety Considerations and Training
RIVA should only be performed by trained professionals due to potential risks like tourniquet failure or accidental systemic spread. Proper technique and monitoring are crucial for patient safety.
Conclusion
Regional intravenous anaesthesia is a highly effective method for limb surgeries, especially in the wrist and hand. With the right expertise and precautions, it offers a safe, efficient, and patient-friendly alternative to general anaesthesia.
For more information on anaesthesia techniques, check out resources from the American Society of Anesthesiologists or this Wikipedia article on Bier’s block.
By understanding the principles and applications of RIVA, medical professionals can provide better care while minimising risks.