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In order to numb the hand and forearm, August Bier originally introduced Intravenous Regional Anesthesia (IVRA) in 1908. Brachial plexus blocks caused the procedure to become less popular, but Holmes brought it back in 1963 by using lidocaine instead of procaine. In circumstances where it is safe and simple to administer an occlusive tourniquet, IVRA is appropriate for surgeries on the distal extremities. Although it can be utilized for treatments affecting the lower extremities, it is primarily employed for surgeries on the upper extremity
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