الفهرس 
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Abstract
Aim of the work
To compare the anesthetic efficacy of levobupivacaine 0.125% versus lidocaine 0.5% and the effect of addition of ketorolac 30mg on the tourniquet tolerance and postoperative analgesia for cases of below elbow ambulatory upper extremity surgery.
Conclusion
Based on the findings of equivalent surgical anesthesia, and decreased potential to produce CNS and cardiac side effects, it seems reasonable to consider levobupivacaine 0.125% as an alternative to lidocaine 0.5% for intravenous regional anesthesia for cases of ambulatory upper extremity surgery, also, the addition of ketorolac to intravenous regional anesthesia has added much benefit in terms of controlling intraoperative tourniquet pain and by diminishing postoperative pain.
So, the combination of levobupivacaine 0.125% with ketorolac 30mg may be most suitable for achievement of surgical anesthesia in cases of ambulatory upper extremity surgery. However, further studies are needed to compare this combination with other combinations of local anethetics and additives for intravenous regional anesthesia.