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Practical experience in the use of Bier block anaesthesia of the upper limb is described. The revival of this well-tested technique is particularly relevant in circumstances where, for a variety of reasons, the administration of a general anaesthetic is impracticable. The quality of surgery, the safety of anaesthesia and the patient's comfort can be well maintained by following a few simple rules. We have satisfied these criteria in this series by using low doses which are safe and sufficient in a busy accident department.
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