One hundred adult patients were randomize to undergo a carpal tunnel release surgery under an ultrasound-guided peripheral nerve block (n=50) or a forearm intravenous regional anesthesia (IVRA; n=50). The primary outcome of interest was peri-operative analgesic efficacy, or quality of the block (complete vs incomplete). Secondary outcomes of interest included the following: pain evaluated using a Numerical Rating Scale (NRS), surgical time, total operative room time, and surgeon and patient satisfaction. NRS pain was measured at incision, during block performance, at discharge, and 24-hours post-surgery. Results of this trial revealed statistically significantly greater block quality in the peripheral nerve block compared to the IVRA group (p=0.019). Surgeon and patient satisfaction were also statistically significantly greater in the peripheral nerve block compared to the IVRA group (p=0.0016; p=0.0023, respectively). Moreover, patients at discharge had a statistically significantly lower pain intensity in the peripheral nerve block vs forearm IVRA group (p<0.001). The proportion of complete blocks was greater in the peripheral nerve block intervention when compared with the control forearm IVRA (p=0.019). All other outcomes were not statistically significantly between the 2 groups at all timepoints (p>0.05 for all).