Ketamine with adrenaline was used as a local anesthetic for the removal of naevi, dermatofibromas, and verrucae in a double-blind study. 1 Laser surgery was used in 10 and excision using a knife in 22 cases. The ketamine concentration employed varied between 12.5 and 20.0 mg/ml. The adrenaline concentration used was 10 microg/ml. The total doses of ketamine used per patient ranged from 12.5 to 30 mg. Anesthesia as tested using the pin prick, was obtained within 1 to 3 minutes after injection and lasted for up to 11 minutes. In all patients, the injection of ketamine caused some smarting that lasted for a few to 15 seconds. Erythema always was observed in the injection area and this observation broke the double-blind code. Extrapyramidal side-effects (light-headedness and dizziness) were reported by 18 (56.2%) of our patients. Conclusion: The use of ketamine as a local anesthetic is similar to the use of lidocaine even when the doses used are small. The only drawbacks of ketamine are its short duration and the high incidence of extrapyramidal sideeffects.