Background: Ketamine is one of the safest medications used in emergency medicine procedural sedation due to its minimal effects on respiratory and cardiovascular systems. This case raises concerns about potential ketamine-delayed respiratory complications in obese patients. Case Presentation: We report the case of an 11-year-old child who underwent emergency department sedation for cut wound repair using ketamine administered intravenously. The patient developed apnea 2 hours after an uneventful sedation while he was in the observation period. The apnea was managed by supplemental oxygen and physical stimulation, and the patient was put on continuous positive airway pressure. He was admitted to the critical care unit for observation and was discharged the next day without complications. Conclusion: Our case highlights the possibility of delayed respiratory complications due to ketamine use in obese children.

Keywords: Case report, Ketamine, Apnea, Sedation, Respiratory Depression