Aim:The aim of this study was to compare the analgesic effects of ketamine-based analgesia versus standard general anesthesia (GA) in trauma patients undergoing surgical interventions. The goal was to evaluate postoperative pain control, opioid consumption, and the incidence of adverse effects. Materials and Methods:This was a prospective, randomized study involving 80 adult trauma patients (aged 18-65 years) who required surgical intervention. The patients were randomly assigned to either the Ketamine Group (Group K) or the Standard GA Group (Group GA). Group K received ketamine-based analgesia, and Group GA received standard GA. Pain scores were assessed using the Numeric Rating Scale (NRS) at 6, 12, and 24 hours postoperatively. Secondary outcomes included total opioid consumption, incidence of postoperative nausea and vomiting (PONV), sedation levels, and adverse events. Results:The results revealed that the Ketamine Group experienced significantly lower postoperative pain scores at all time points (6, 12, and 24 hours) compared to the Standard GA Group (p-values < 0.05). Additionally, the Ketamine Group showed significantly reduced opioid consumption during the first 24 hours (12.5 mg vs. 20.4 mg morphine equivalent, p = 0.04). The incidence of PONV was lower in the Ketamine Group (25% vs. 45%, p = 0.04). Hallucinations were more common in the Ketamine Group (10% vs. 0%, p = 0.02), but no significant differences in delirium or respiratory depression were observed. The length of hospital stay was similar between the two groups. Conclusion:Ketamine-based analgesia provided superior postoperative pain control and reduced opioid consumption compared to standard general anesthesia in trauma patients. Although the incidence of hallucinations was higher with ketamine, the overall safety profile was favorable, suggesting that ketamine is an effective adjunct for pain management in trauma patients.