lntroduction: Demolitive maxillofacial facial surgery presents high intensity of postoperative pain associated with difficulty in airway management. Postoperative pain in maxillofacial surgery is one of the most severe type of pain. In our clinical practice we decided to introduce oxycodone in association with ketamine as a new postoperative pain management to achieve good analgesia (NRS < 4) without delaying extubation times, reducing the incidence of opioids respiratory depression. 
Methods: After approval of the Local Ethics Committee and lnformed
Consent, 24 patients undergoing demolitive maxillofacial surgery were enrolled. At the end of surgery, ketamine 0.5 mg / kg was given as a bolus followed by a continuous infusion of ketamine 0.25mg/kg /h and Oxycodone 2mg /kg/h upon recovery in ICU. All recruited patients
belonged to ASA class I or II. The extubation parameters were VT> 6ml / kg, spontaneous FR 14 - 16 acts per minute, PEEP 4 and PS 12 in CPAP + PS ventilation mode.
Results: In all patients treated with ketamine + oycodone in continuous infusion we achieved a valuable pain relief (NRS < 4) with a reduction in extubation time. In addition, we reported no episodes of re-intubation and only 3 episodes of rilevant desaturation (Sp02 < 90%) treated with NIV. 
Conclusion: The association of Oxycodone and Ketamine, ensuring a satisfactory postoperative pain control and shortening the extubation times with reduced incidence of respiratory complications, could be the new therapeutic standard for the treatment of postoperative pain in this kind of surgery.

INTRAVENOUS OXYCODONE AND KETAMINE IN DEMOLITIVE MAXILLOFACIAL SURGERY