Role of Dexmedetomidine–Ketamine ("Ketodex") in Day-Care Surgery: A Contemporary Evidence-Based Narrative Review

Dr. Yoshitha Reddy¹, Dr. Dilip Kumar^2*

¹ Postgraduate Resident, Department of Anaesthesiology, Shri Sathya Sai Medical College and Research Institute, Kancheepuram District, Tamil Nadu, India. Email: yoshigsr.reddy1992@gmail.com

^2* Professor, Department of Anaesthesiology, Shri Sathya Sai Medical College and Research Institute, Kancheepuram District, Tamil Nadu, India. (Corresponding Author) Email: dilipko@gmail.com

Author Contributions
Dr. Dilip Kumar conceptualized and supervised the case management.
Dr. Yoshitha Reddy was involved in data collection and manuscript preparation.
Both authors contributed to clinical management, critically revised the manuscript, and approved the final version.

Declaration
Conflicts of Interest: The authors declare no conflicts of interest.
Funding: No financial support was received for this study.

Received: 20th Feb, 2026 | Revised: 4th Mar, 2026 | Accepted: 25th Mar, 2026 | Available Online: 10th Apr, 2026

ABSTRACT

Introduction: Day-care (ambulatory) surgery has become an integral component of modern surgical practice, emphasizing rapid recovery, minimal complications, and early discharge. Finding the right balance between sedation, pain relief, haemodynamic stability, and recovery is still a major challenge in anaesthetic management. The combination of dexmedetomidine and ketamine (Ketodex) has emerged as a viable multimodal therapy because to its complementing pharmacological properties.

Aim: To critically assess the pharmacological foundation, clinical effectiveness, safety profile, and usability of the dexmedetomidine–ketamine combination in day-care surgical settings.

Materials and Methods: This narrative review utilized a systematic literature search across PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library for studies published between 2020 to 2025. Included were pertinent randomized controlled trials, systematic reviews, meta-analyses, and observational studies assessing Ketodex in procedural sedation and ambulatory surgery. A qualitative synthesis methodology was employed to examine outcomes pertaining to analgesia, hemodynamic stability, recovery trajectory, and side effects.

Results: Ketodex demonstrates a favorable therapeutic profile, marked by efficient sedation, enhanced analgesia, less opioid necessity, and the maintenance of respiratory function. The combination enhances hemodynamic stability via synergistic autonomic actions and is linked to a more seamless recovery and a reduced occurrence of postoperative nausea and vomiting. Nonetheless, significantly extended recovery duration and dose-dependent hemodynamic effects, including bradycardia, persist as significant factors.

Conclusion: The dexmedetomidine–ketamine combination is a balanced and effective way to put someone to sleep for day-care surgery. It has many benefits in terms of safety, pain relief, and patient comfort. Ketodex is not always better than other standard treatments, however it is a useful option in some cases. Additional extensive, systematic research are necessary to determine its conclusive significance in ambulatory anesthesia.

Keywords: Dexmedetomidine; Ketamine; Ketodex; Day-care surgery; Ambulatory anaesthesia; Procedural sedation; Multimodal analgesia.

How to cite this article: Reddy Y, Kumar D. Role of Dexmedetomidine–Ketamine ("Ketodex") in Day-Care Surgery: A Contemporary Evidence-Based Narrative Review. Int J Drug Deliv Technol. 2026;16(31s):15-26. DOI: 10.25258/ijddt.16.31s.3

Source of support: Nil.

Conflict of interest: The authors declare no conflicts of interest.