August Karl Gustav Bier (24 November 1861, Bad Arolsen – 12 March 1949) was a German surgeon and a pioneer of spinal anaesthesia. After professorships in Greifswald and Bonn, Bier became a professor at the Charité in Berlin.
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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 cocaine 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 flowing freely from it, the syringe 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.
Bier pioneered the use of intravenous regional anaesthesia in 1908. To this day, this technique is commonly referred to as a "Bier block".