Abstract In this study, two groups of patients undergoing intravenous regional anaesthesia (IVRA) for surgery on the forearm or hand have been compared. The first group received 0.5% lignocaine while the second received 0.25% lignocaine+fentanyl 1 μg kg −1 and mivacurium 1 mg. A prior study comparing 0.5% lignocaine to pancuronium 0.5 mg with 0.25% lignocaine and fentanyl 1 μg kg −1 showed a faster onset of motor block in the 0.5% lignocaine group . This study demonstrates a significantly faster onset of motor block in the mivacurium-administered group. The potential advantage of mivacurium is its non-organ dependent metabolism by plasma cholinesterase. There was no difference in the onset of the sensory block. It is well known that there is little postoperative analgesia associated with conventional Bier’s block. The study found lower pain scores in the second group 45 min and 1 h post-operatively. Anaesthesia was successful in all cases and none of the patients experienced muscle weakness after tourniquet release.