AIM: Intravenous regional anaesthesia (IVRA) is a safe, effective technique for surgery on the upper extremities, but it provides no postoperative analgesia. The aim of this study was to evaluate the analgesic efficacy of small dose of ketoprofen with IVRA induced by lidocaine. METHODS: Forty eight patients undergoing ambulatory hand surgery were randomly assigned to one of three groups: They received 40 mL of 0.5% lidocaine and either 1 mL of isotonic saline (group Control, n = 16) or 50 mg Ketoprofen (group K50, n = 16) or 100 mg Ketoprofen (group K100, n = 16).Visual analogue scale was recorded for 2 h postoperatively. Postoperative pain was treated with morphine in post anesthesia care unit (PACU) and oral acetaminophen at home. RESULTS: The sensory recovery time was longer in the group K100 compared to control group (p < 0.01). There was a statistically significant lower VAS in group K100 compared to control group, but not between group K50 and control group or group K50 and group K100. The K100 group needed significantly less morphine in the PACU when compared with control group or K50 group. Postoperative analgesic consumption (acetaminophen) was statistically lower during the first 24 h in group K100 compared to others groups. CONCLUSION: The addition of 100 mg ketoprofen but not 50 mg to lidocaine for IVRA in patients undergoing hand surgery improves postoperative analgesia during the first postoperative day. [ABSTRACT FROM AUTHOR]