Background: intravenous regional anesthesia (IVRA) was first described by August Bier in 1908. IVRA is an anesthetic technique for surgical procedures on the body's extremities where a local anesthetic is injected intravenously. The local anesthetic diffuses from the peripheral vascular bed to nonvascular tissue such as axons and nerve endings. Objective: The aim of the present study was to compare the effect of adding ultra-low dose of naloxone to lidocaine for IVRA and the effect of using intravenous naloxone infusion with IVRA for elective short procedures in the upper limb. Patients and Methods: This is Prospective; randomized, controlled, multicenter, double blind study that done in Alazhar University hospitals.  Each group contains 30 patients. The lidocaine in the study is 2% 3mg/kg in all groups. In all groups 0.9% NaCl is added to make up a total volume of 30 ml. Results: The result of our study showed that local intravenous adjuvant naloxone (100 or 50ng) with lidocaine 1 % shortens the onset of blocks and prolongs the recovery from anesthesia. Moreover, it reduces the amount of opioids consumption and intraoperative pain score in patient undergoing short upper limb surgeries. Conclusion: Naloxone IV infusion not improves the analgesic effect of intravenous anesthesia or prolongs the recovery from anesthesia. Regarding safety, adjuvant naloxone appears to be safe with no recorded side effects.