Ketamine is a unique IV anesthetic with analgesic-like properities that has been used for both induction and maintenance if anesthesia, as well as an analgesic adjunctive during local anesthesia. Adjunctive use of small dose keamine (0.1 – 0.2 mg/kg IV) appear to be associated with opioid-sparing effects and a less frequent incidence of adverse events and greater patient and physician acceptance.