A comparison of plain prilocaine and bicarbonated prilocaine in intravenous regional anesthesia was studied in 30 patients undergoing upper extremity surgery. The patients were divided into two groups: one group was given anesthesia in the form of 1 % prilocaine and the other group was given 1 % prilocaine plus sodium bicarbonate. The onset of analgesia and anesthesia and recovery from analgesia and anesthesia were investigated in both groups. Bicarbonated prilocaine produced faster onset of analgesia when compared with plain prilocaine (P < 0.01). The onset of anesthesia and recovery from analgesia and anesthesia were not statistically different between the two groups. Clinically, the intensity of anesthesia was better when bicarbonated prilocaine solution was used instead of plain prilocaine. We conclude that bicarbonated prilocaine is better than plain prilocaine during IVRA.