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Abstract Intravenous regional anesthesia (I.V.R.A.) is a simple ,safe, and effective method of providing anesthesia for extremity surgery. The technique was first described in 1908 by August Bier ,a German surgeon who also introduced spinal anesthesia into clinical practice 10-years earlier. In some countries ,IVRA is referred to as Bier block. Good surgical anesthesia can be achieved rapidly after injection of local anesthetic and the recovery is fast after the release of the tourniquet .No other regional anesthesia technique provides such a control over the onset ,duration, and recovery of block. The published success rates range from 94% to lOO%) . |