Abstract Introduction: Intravenous regional anaesthesia was first described in 1908 by August kar Gustav Bier, a German surgeon and pioneer of spinal anaesthesia, for anaesthesia of forearm and hand. He described a new method of producing analgesia of limb which he named ‘vein anaesthesia’. August bier first presented his new method of intravenous regional anaesthesia at the 37^th congress of the german surgical society on 22^nd April 1908.Dexmedetomidine, an imidazole compound, is the pharmacologically active dextroisomer of medetomidine. It is a potent alpha-2 adrenoceptor agonist with eight times higher affinity for the alpha-2 adrenoceptor than clonidine, Alpha-2 agonists produce sedation, analgesia, hypnosis, anxiolysis and sympatholysis. Aims and Objectives: To evaluate the anaesthetic and analgesic effectivenss of Dexmedetomidine and acetaminophen when administered as adjuncts to lidocaine in intravenous regional anaesthesia to find out sensory and motor block onset times. Methodology: This was a clinical trial, in this patients were divided randomly into three group of 30 patients each. Patients were divided into GROUP I: Control Group, GROUP II: Dexmedetomidine. GROUP III: Paracetamol (Acetaminophen).The data was analyzed using computer software microsoft excel and SPSS version 10.0 for windows. The data was presented as mean and standard deviation and statistical significance was analyzed using one-way analysis of variance (ANOVA). Post-hoc intergroup significance was assessed using bonferroni, s t test. A ‘p’ value of <0.05 was considered statistically significant. Qualitative variable was analyzed using chi-square test. All analysis was conducted in accordance to intention to treat principle. Result: Onset of sensory block was significantly lower in Group II and Group III as compared to Group III (0.0001), Onset of Motor block was significantly lower in Group II and Group III as compared to Group III (0.0001). Excellent Quality of anesthesia was significantly higher in Group II as compared other groups (0.00001). There was significantly lower Visual Analogue Scale in Group II as compared to other groups, among intra-operative analgesia at 10, 20, and 30,40,50,60. Conclusion: It is concluded that the addition of dexmedetomidine or acetaminophen to lidocaine in intravenous regional anaesthesia definitely improve the quality of anaesthesia and analgeisa to a variable extent. However, dexmedetomidine is more potent, and provides better quality of anaesthesia and analgesia, and prolongs the duration of postoperative analgesia more than acetaminophen

Keywords: Quality of Anesthesia, Dexmedtomidine, Acetaminophen.