A 6-year-old female in good health presented with no known drug allergies for dental treatment under general anesthesia. Following the preoperative evaluation, the patient received intramuscular premedication consisting of midazolam (1 mg) and Ketamine (60 mg) into the left deltoid muscle. During patient transfer, anesthesia personnel detected a hive developing in proximity to the patient's right ear lobe. The subject was directly placed into the operative chair, and a physical exam revealed urticaria on the neck, back, and torso. In addition, an audible wheeze was detected with lung auscultation. Investigations carried out after the incident revealed a positive reaction to ketamine