Recurrent Episodes of Intractable Laryngospasm During Dissociative Sedation With Intramuscular Ketamine

We report 2 cases of dissociative sedation with intramuscular ketamine with recurrent episodes of laryngospasm that we were unable to ventilate with bag-mask ventilation, in 1 case leading to endotracheal intubation to protect the airway. Supplemental oxygen was given throughout the sedations, and ventilatory status was noninvasively monitored on a continuous basis, providing detailed and objective documentation of the patients' clinical status throughout the sedations. We were, therefore, able to rapidly assess and confirm apnea, laryngospasm, and airway dysfunction.