Background: Recently demonstration of opioid receptors along peripheral sensory nerves especially after painful inflammatory conditions forms the basis of peripheral opioid analgesia. This form of opioid antinociception has the potential to help overcome one of the disadvantages of intravenous regional anesthesia (IVRA) that is lack of postoperative analgesia. The aim of the study was to assess the efficacy of Buprenorphine as an adjunct to lidocaine in (IVRA) for postoperative analgesia. Methods: Seventy-five consenting patients undergoing hand & forearm surgery were randomly allocated into three groups of twenty-five each: group A received 0.5% 40 ml lidocaine for IVRA, group B received 0.5% 40 ml lidocaine for IVRA and Buprenorphine 0.3 mg intramuscularly and group C received 0.5% 40 ml lidocaine with Buprenorphine 0.3 mg for IVRA. Postoperative analgesia was assessed using visual analog scale (VAS) on a 0 to 100 mm scale in the immediate postoperative period and 1 hourly thereafter for 24 hours. Patients were given declofenac 1 mg/kg orally whenever VAS score exceeded 25 or patient demanded analgesic. Results: Onset time for sensory block was longer in group C as compared to group A & B (5.0±1.0 min versus 4.0±0.6 and 4.0±0.4) whereas motor block onset time was comparable in all the three groups. Quality of sensory & motor block was similar in all the groups. Duration of postoperative analgesia was significantly longer in group C (20 ±2 hrs) as compared to 0.7±0.2 and 7±0.6 hrs for group A & B respectively (p=0.001). Analgesic consumption was also significantly lower in group C (56±9 mg versus 201±27 & 120±24 mg for group A & B respectively (p=0.001). incidence of nausea/vomiting and sedation was much higher in group B as compared to other groups (p=0.002). Conclusion: We concluded that addition of Buprenorphine 0.3 mg to lidocaine for IVRA significantly prolongs analgesia without causing systemic side effects.