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Progression of Forearm Intravenous Regional Anesthesia With Ropivacaine
  1. Jean-Louis Horn, MD*,
  2. Paul Cordo, PhD,
  3. Daniela Künster, PhD,
  4. Christopher Harvey, BS*,
  5. Anne Cherry, BS§,
  6. Alexander Bratt, BS and
  7. Victor Gurfinkel, PhD
  1. From the Departments of *Anesthesiology, and
  2. Science & Engineering, Oregon Health & Science University, Portland, OR;
  3. Department Physical Medicine, University of Freiburg, Germany;
  4. §Division of Medical Sciences, Harvard University, Boston, MA; and
  5. College of Physicians & Surgeons, Columbia University, New York, NY.
  1. Address correspondence to: Jean-Louis Horn, MD, Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHS-2, Portland, OR 97239 (e-mail: hornj{at}


The progression of sensory blockade in the hand following a forearm Bier block with ropivacaine is currently unknown. The hands of 10 healthy adult human subjects were anesthetized with ropivacaine, and their sensitivities to cold and touch were tested until the completion of anesthesia. On average, insensitivity to cold occurred uniformly throughout the hand within 9 mins; however, touch sensation was not complete until approximately 20 mins after injection. The spread of anesthesia occurred in a semisystematic way, spreading proximally and distally from the site of injection (mid-dorsum of the hand), and, at a slower rate, from the dorsum of the hand to the palm.

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  • The research described in this article was supported by National Institutes of Health grant 2R01NS061304-21.