BACKGROUND: Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist with analgesic properties. This study was undertaken to evaluate the potential utility of epidural ketamine combined with meperidine and bupivacaine for postoperative patient-controlled epidural analgesia (PCEA) after cesarean section. METHODS: Forty-five patients received epidural catheterization in the L3-4 intervetebral space and underwent cesarean section under epidural anesthesia. In the recovery room, these patients were randomly allocated to 3 groups; group I (control; n = 15) received 1 mg/ml bupivacaine and 1 mg/ml meperidine, group II (n = 15) received 1 mg/ml bupivacaine and 1 mg/ml meperidine with 0.25 mg/ml ketamine, group III (n = 14) received 1 mg/ml bupivacaine and 1 mg/ml meperidine with 0.75 mg/ml ketamine using a PCEA device for postoperative pain control. The analgesic effects and PCEA consumption were assessed at 6, and 24 hours after surgery. Side effects were also evaluated. RESULTS: There were no statistically significant differences in the visual analogue scale for pain, the consumption of the analgesics and side effects among the groups. CONCLUSIONS: Epidural ketamine combined with bupivacaine and meperidine did not improve postoperative analgesia, nor did it reduce consumption of the analgesics and side effects.