Emerg Med J 30:214-217 doi:10.1136/emermed-2011-200999
  • Original article

Is lidocaine Bier's block safe?

  1. Stacy Turner1
  1. 1Emergency Department, Royal United Hospital, Bath, UK
  2. 2Bristol Medical School, Bristol, UK
  1. Correspondence to Dr Nicola Jakeman, Emergency Department, Royal United Hospital, Bath BA1 3NG, UK; nicola.jakeman{at}
  1. Contributors NJ: Developed the idea and led the project, guided data analysis and interpretation, critically reviewed and rewrote large sections of the paper and gave final approval to the published version. PK: Shared data collection, analysis and interpretation, helped with revision of the article and approved final version. JH: Shared data collection and analysis, wrote first draft of paper and approved final version. DPW: Shared data collection, analysis and interpretation, critically analysed article for intellectual content and approved final version. ST: Shared data collection, reviewed and revised article and approved final version.

  • Accepted 3 March 2012
  • Published Online First 23 May 2012


Objectives To assess the safety profile of lidocaine Bier's block when compared with that of prilocaine.

Method A retrospective audit of patients undergoing Bier's block using 0.5% lidocaine during a 27-month period (April 2008–June 2010) at the Royal United Hospital Bath emergency department.

Results 416 patients with sufficient data were included in the study; 360 women and 56 men. The mean patient age was 65 years. Complications were reported in 39 cases; transient hypotension/vasovagal episodes and transient mild bradycardia were most frequent. No patients required any medical intervention. There was no occurrence of anaphylaxis, convulsion, hypotensive episodes requiring medical intervention, collapse or death.

Conclusion No clinically significant morbidity or mortality as a consequence of lidocaine Bier's block was demonstrated in this audit.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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