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.