Background: The use of adjuncts with local anaesthetics improve the quality of sensory block and prolong the postoperative analgesia in Intravenous Regional Anaesthesia (IVRA). Material and Methods: Ninety adult American Society of Anaesthesiologists (ASA) I and II patients in the age group of 20-50 years scheduled to undergo upper limb surgery were randomly divided into three groups (n=30). Group LT received lignocaine 3mg/kg with tramadol 50 mg; Group LB patients received lignocaine 3mg/ kg with butorphanol 1mg and Group L received lignocaine 3mg/kg alone. Double tourniquet technique was used. Hemodynamic changes, onset of sensory block, need for analgesic supplement, time to first rescue analgesic requirement in the post-operative period and adverse effects were compared in the three groups. Stastical Analysis was performed using Chi-square test and students unpaired t-test. Results: The mean time of onset of analgesia was 3.35±1.24 min in Group LT, 3.5±2.4 min in Group LB and 5.5±1.23 min in Group L. Analgesic supplementation was required in 10%, 13.33% and 16.67% patients in Group LT, Group LB and Group L respectively. The mean time to first postoperative analgesic requirement was 282.5±9.84 min in Group LT, 184.50±9.25 min in Group LB and 124.5±14.25 min in Group L. Conclusion: The addition of tramadol or butorphanol to lignocaine in IVRA enhances the onset of sensory block, improves the quality of the block and provides prolonged postoperative pain relief with minimal adverse effects as compared to lignocaine alone.