Playing this way with a partner really lessens your chance of experiencing complications and makes more play options available for the simple reason that you will have someone to help you if you pass out. Aside from that, if you have some form of injury occur you will have someone to help you get assistance. The main downside to play with a partner is that you have to spend a lot of time finding the person you will literally trust your life with and if something goes horribly wrong you may end up convicted of a crime or having your lover convicted of a crime. The physiological things mentioned in another section will all still be present so even if you play very "safe" you could end up drawing the short straw and taking the consequences. Out of 25 million people in the US, it is estimated that 250 will die of erotic asphyxiation in a year. Of those 250 almost all of them will be auto-erotic asphyxiation (solo play). Therefore, statistically your chances of partner play going wrong are pretty darn low if you pay attention to avoiding the risks you can control. With that in mind...let's talk about how things could be done and how to lower the risks.