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stress of laryngoscopy and volatile anesthetics, general anesthesia was avoided. The technique of brachial plexus block with local anesthetic 0.5% bupivacaine plain also had the potential of increased risk of ventricular tachyarrythmias due to cardiac toxicity. Due to the need for urgent surgery under tourniquet because of impending rupture, an IVRA technique was planned. Since the ventricular bigeminy of the patient had earlier responded to intravenous lignocaine, IVRA with lignocaine was likely to be safe even in case of systemic absorption.

Intravenous regional anesthesia as an anesthetic technique for a patient with ventricular bigeminy