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Abstract In 1908, August Bier, professor of surgery at Berlin, described an unusual method of producing analgesia of a limb. He isolated a segment of the limb, after exsanguinations between two bandages. A previously marked vein was exposed under local infiltration and a canula, directed distally, was tied into that vein through which procaine was injected( 6 ). In 1931, Morrison was the first to suggest the use of venopuncture and he used one tourniquet only. In 1963, Holmes revived the technique of IVRA by inflating a sphygmomanometer cuff above the systolic pressure after exsanguination of the limb by an Esmarch bandage and using lidocaine 0.5%. He also used a second cuff over the analgesic part of the limb to avoid tourniquet discomfort |