• S A W Pickering and J B Hunter.
• Department of Trauma and Orthopaedic Surgery, University Hospital, Queen's Medical Centre, Nottingham, NG7 2UH, UK. simonpickering@tiscali.co.uk
• Surg J R Coll Surg E. 2003 Oct 1;1(5):283-5.

ObjectivesTo examine the safety of prilocaine Bier's block performed for Colles fracture manipulation, and assess patient satisfaction.MethodFifteen-year retrospective review of all patients undergoing Colles fracture manipulation with a prilocaine Bier's block looking for the incidence of significant neurological or cardiovascular events. A confidential questionnaire was administered to 50 consecutive patients to assess patient satisfaction with the method of anaesthesia.Results1504 males with mean age 48 years and 5906 females with mean age 66 years received a prilocaine Bier's block for distal radial fracture manipulation. There were no documented incidences of anaphylaxis, arrhythmia, convulsions or collapse. Of 50 consecutive patients, all but two were satisfied with this form of anaesthesia. The pressure cuff inflation was considered the worst part of the procedure.ConclusionBier's block performed with prilocaine is at least as safe as other commonly used methods of anaesthesia for distal radial fracture reduction with high patient satisfaction. The procedure can be safely carried out by a single medical practitioner with appropriate patient monitoring and assistance from trained nursing staff.

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