Easy with mysql:

$dbh->do('insert mumble');
my $id = $dbh->{'mysql_insertid'};
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a bit harder with sql server through odbc:

$dbh->do("set nocount on"); # so it works on SQL Server 6.5 too
my $sth = $dbh->prepare(
    "insert mumble
    SELECT @@IDENTITY ID");
$sth->execute;
my $id = $sth->fetchrow_arrayref->[0];
$sth->finish;
$dbh->do("set nocount off");
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You may find that access has enough in common with sql server to accept this syntax. I couldn't find any conclusive information either way.