Elgebaly AS, et al. - The nitroglycerin patch was assessed as a new additive to Bier’s block and its impact on the effects and dose of lidocaine was also determined. A reduction was evident in the lidocaine dose, the sensory and motor block onset times, visual analogue scale (VAS) scores, and analgesic consumption intra- and postoperatively as a result of supplementation of Bier’s block with transcutaneous nitroglycerin patch. Furthermore, this strategy provided improved quality of Bier’s block with better patients’ satisfaction and surgeons’ opinion, with no adverse effects, via prolonging the length of the block recovery times for the sensory and motor effects as well as duration of postoperative analgesic effect, and delaying the first time to analgesic requirement.