August Bier
Encyclopedia
Bad Arolsen
Bad Arolsen is a small town in northern Hesse, Germany, in Waldeck-Frankenberg district. From 1655 until 1918 it served as the residence town of the Princes of Waldeck-Pyrmont and then until 1929 as the capital of the Waldeck Free State...
– 12 March 1949) was a German
Germany
Germany , officially the Federal Republic of Germany , is a federal parliamentary republic in Europe. The country consists of 16 states while the capital and largest city is Berlin. Germany covers an area of 357,021 km2 and has a largely temperate seasonal climate...
surgeon
Surgeon
In medicine, a surgeon is a specialist in surgery. Surgery is a broad category of invasive medical treatment that involves the cutting of a body, whether human or animal, for a specific reason such as the removal of diseased tissue or to repair a tear or breakage...
and a pioneer of spinal anaesthesia
Spinal anaesthesia
Spinal anaesthesia , also called spinal analgesia or sub-arachnoid block , is a form of regional anaesthesia involving injection of a local anaesthetic into the subarachnoid space, generally through a fine needle, usually 9 cm long...
. After professorships in Greifswald and Bonn
University of Bonn
The University of Bonn is a public research university located in Bonn, Germany. Founded in its present form in 1818, as the linear successor of earlier academic institutions, the University of Bonn is today one of the leading universities in Germany. The University of Bonn offers a large number...
, Bier became a professor at the Charité
Charité
The Charité - Universitätsmedizin Berlin is the medical school for both the Humboldt University and the Free University of Berlin. After the merger with their fourth campus in 2003, the Charité is one of the largest university hospitals in Europe....
in Berlin
Berlin
Berlin is the capital city of Germany and is one of the 16 states of Germany. With a population of 3.45 million people, Berlin is Germany's largest city. It is the second most populous city proper and the seventh most populous urban area in the European Union...
.
Spinal anesthesia
Bier performed the first planned spinal anaesthetics on a series of 6 patients for lower extremity surgery. Each of them received a spinal dose of cocaineCocaine
Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. The name comes from "coca" in addition to the alkaloid suffix -ine, forming cocaine. It is a stimulant of the central nervous system, an appetite suppressant, and a topical anesthetic...
and did well except for having nausea, vomiting and headache afterwards. After this series, Bier was to receive a spinal anesthetic administered by his assistant, August Hildebrandt. Unfortunately, although the spinal needle was placed correctly, with cerebrospinal fluid
Cerebrospinal fluid
Cerebrospinal fluid , Liquor cerebrospinalis, is a clear, colorless, bodily fluid, that occupies the subarachnoid space and the ventricular system around and inside the brain and spinal cord...
flowing freely from it, the syringe
Syringe
A syringe is a simple pump consisting of a plunger that fits tightly in a tube. The plunger can be pulled and pushed along inside a cylindrical tube , allowing the syringe to take in and expel a liquid or gas through an orifice at the open end of the tube...
was only then discovered to not fit the needle. As a result, Dr Bier gained first-hand knowledge of the unpleasant post-spinal headache. Dr Hildebrandt instead became the recipient of the cocaine spinal anaesthetic. After the injection, Dr Hildebrandt's legs became numb and the two celebrated their success with wine and cigars. The profound analgesia of his legs was demonstrated with repeated kicks to his shins, which however, soon regained their sensation.
Intravenous regional anaesthesia
Bier pioneered the use of intravenousIntravenous therapy
Intravenous therapy or IV therapy is the infusion of liquid substances directly into a vein. The word intravenous simply means "within a vein". Therapies administered intravenously are often called specialty pharmaceuticals...
regional anaesthesia
Regional anaesthesia
Regional anaesthesia is anaesthesia affecting only a large part of the body, such as a limb or the lower half of the body. Regional anaesthetic techniques can be divided into central and peripheral techniques. The central techniques include so called neuraxial blocks...
in 1908. To this day, this technique is commonly referred to as a "Bier block
Intravenous regional anesthesia
Intravenous regional anesthesia or Bier block anesthesia is a common anesthetic technique for surgical procedures on the body's extremities where a local anesthetic is injected intravenously. The technique usually involves exsanguination, which forces blood out of the extremity, followed by the...
".
Further reading
- "This won't hurt a bit," New Scientist, vol 173 issue 2330 - 16 February 2002, page 48.
- "The Centennial of Spinal Anesthesia," Anesthesiology, August 1998 - Volume 89 - Issue 2 - pp 500-506.