S-MART™ - The Safer IVRA (Bier Block) Method -- MEDICA - World Forum for Medicine


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S-MART™ - The Safer IVRA (Bier Block) Method

The Intra Venous Regional Anesthesia method (IVRA) was invented in 1908 by August Karl Gustav Bier and has been used regularly since 1963(1). Although this method is considered as a relatively safe practice, many physicians are still apprehensive of using it. Usually, the procedures done under IVRA are limited to an hour and most risks involved are the outcome of pneumatic tourniquet leaks shortly after injecting the limb with anesthetic solution.

The S-MART™ surgical exsanguination tourniquet is now used regularly in procedures involving IVRA and has proven to be safer than the classic methods.
• The S-MART™ can be placed lower on the forearm or calf and the amount of anesthetic solution used can be reduced substantially.
• The risk of confusing the distal and proximal tourniquet cuff is eliminated.
• There is no risk of sudden loss of tourniquet pressure.
• Procedures can last more than an hour as there is no danger of tourniquet discomfort (as soon as there is some discomfort, the tourniquet is rolled distally to the anesthetized area).

Bier A: Ueber einen neuen Weg Lokalanasthesie an den gliedmassen zu Erzcugen. Verh Dtsch Ges Chir 27:204, 1908.