A case of CO₂ narcosis caused by a preoperative administration of a sleep-inducing drug

Abstract

We experienced a case of CO₂ narcosis caused by 2 mg of rilmazafone hydrochloride (Rhythry^®) adminstered at the night prior to an operation. A 72-year-old female scheduled for right total hip replacement because of rheumatoid arthritis with complications of chronic rheumatism, restrictive pulmonary disease, an electrolytic abnormality, and low body weight (32 kg) . When she was transferred to our operating room, she was lethargy and blood gas analysis revealed hypercapnia of Pa_CO2 87 mmHg. Although she was given doxapram and fulmazenil, she was narcotic owing to hypercapnia. She needed mechanical ventilatory support for more than 36 hours. Rilmazaf one-induced depression of the respiratory center would be responsible for narcosis with hypercapnia.
It is, therefore, important to select a drug and it's dose depending on a patient status.