Intra venous regional anesthesia of hand and forearm holds an important place in developing countries because of its simplicity, safety, and economy. Anesthesiologists have been striving for many years to improve the efficacy and duration of regional anesthesia by injecting opioids close to nerve trunks or nerve endings. Opioids are most commonly used as adjuncts in IVRA along with local anesthetics. There is paucity of literature on the use butorphanol, in IVRA. We evaluated the effects of addition of butorphanol to lignocaine in Bier's block. We found that addition of 1 mg butorphanol tartrate to lignocaine in IVRA prolongs the time to request for first rescue analgesic and lessens the 24 hour total postoperative analgesic requirement. We recommend the use of butorphanol 1 mg as an adjunct to lignocaine in IVRA as it provides better postoperative analgesia, reduces requirement of postoperative rescue analgesics, and has a good safety profile.