Regional anaesthesia: Bier's block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Regional anaesthesia: Bier's block

Sample item

Which local anaesthetic is appropriate for intravenous regional anaesthesia (Bier's block)?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Prilocaine or lignocaine 0.5% without adrenaline

Prilocaine 0.5% is preferred because of its low toxicity, and lignocaine 0.5% is the usual alternative in India. Bupivacaine is contraindicated because accidental tourniquet failure causes cardiac arrest.

Option by option

  • A. Bupivacaine 0.5%

    Bupivacaine's cardiotoxicity makes it unsafe.

  • B. Ropivacaine 0.75%

    Ropivacaine 0.75% is not used for this block.

  • C. Lignocaine 2% with adrenaline

    Adrenaline must not be added.

  • D. Prilocaine or lignocaine 0.5% without adrenaline (correct)

    Correct. Dilute lignocaine or prilocaine is used.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Prilocaine or lignocaine 0.5% without adrenaline. Prilocaine 0.

Why is "Bupivacaine 0.5%" not the answer?

Bupivacaine's cardiotoxicity makes it unsafe.

Why is "Ropivacaine 0.75%" not the answer?

Ropivacaine 0.75% is not used for this block.

Why is "Lignocaine 2% with adrenaline" not the answer?

Adrenaline must not be added.

What concept does this question test?

It tests Regional anaesthesia: Bier's block in Anaesthesia. 5% is preferred because of its low toxicity, and lignocaine 0.5% is the usual alternative in India. Bupivacaine is contraindicated because accidental tourniquet failure causes cardiac arrest.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Regional anaesthesia: Bier's block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.