Background: Clonidine, a selective a2 adrenergic agonist, increases the duration of anesthesia and analgesia when it is used with local anesthetics. This study was undertaken to evaluate whether c1onidine, which was mixed with lidocaine for the brachial plexus block (BPB), has a local (peripheral) or a systemic (central) anesthetic effect. Methods: Seventy patients scheduled for upper extremity surgery were randomly allocated to two groups. In group IV (n = 35) an axillary perivascular BPB was performed with 40 ml of I % lidocaine and I : 200,000 epinephrine, and just after BPB c10nidine 2 tJg/kg was administered intravenously. In group BPB (n = 35) the same BPB was performed with 40 ml of I % lidocaine, 1 : 200,000 epinephrine and c10nidine 2 tJg/kg. The following variables were recorded: onset time, duration of anesthesia and analgesia, and adverse effects. Results: Onset time was comparable in both groups. The duration of anesthesia and analgesia signi￢ficantly increased to 306 min and 354 min in group BPB, when compared to 119 min and 151 min in group IV, respectively. No side effects such as hypotension, bradycardia, and sedation were reported. Conclusions: The duration of anesthesia and analgesia is prolonged by adding c10nidine to lidocaine during brachial plexus block, which suggests that its effect is local rather than systemic.