Bier's block--the experience of Australian emergency departments

Med J Aust. 1994 Feb 7;160(3):108-11.


Objective: To describe the current use, effectiveness and safety of Bier's block within Australian emergency departments.

Design: A review of clinical practice based on an opinion survey of directors of emergency departments.

Participants: Directors of 120 private and public hospital emergency departments.

Results: A response rate of 97% was achieved. Bier's block was used in 67% of Australian emergency departments. Emergency department medical staff performed the procedure in 83% of these hospitals. It was estimated that 7500 emergency department Bier's blocks were performed each year. Ninety-six per cent of respondents found Bier's block to produce adequate regional anaesthesia. Reported complications or adverse reactions were extremely rare. A wide variation in procedural approach was evident.

Conclusions: Bier's block is a popular, reliable and relatively safe anaesthetic technique for use in emergency departments. Increased surveillance of local anaesthetic morbidity associated with the technique, as well as a standardisation of the procedure in the emergency department setting, are required.

MeSH terms

  • Anesthesia, Conduction / adverse effects
  • Anesthesia, Conduction / statistics & numerical data*
  • Anesthesia, General / statistics & numerical data
  • Anesthesia, Intravenous / statistics & numerical data*
  • Australia
  • Emergency Service, Hospital / standards
  • Emergency Service, Hospital / statistics & numerical data*
  • Humans
  • Lidocaine
  • Monitoring, Physiologic
  • Prilocaine / adverse effects
  • Treatment Outcome


  • Prilocaine
  • Lidocaine