Non-specific respiratory compromise: A combination of drugs may have contributed. Often patience is all that is required to allow for metabolism and excretion. Doxapram, a ventilatory stimulant, can be considered.
Opioid overdose: Pinpoint pupils might lead you to this diagnosis. Naloxone is a specific and effective antidote. However, it will also reverse the analgesic effects of opioids.
Residual neuromuscular block: A nerve stimulator will guide you here. After longer cases, don’t assume that all the muscle relaxant has been metabolized.
Benzodiazepine overdose: Flumazenil is a specific benzodiazepine antagonist. Use it if you suspect a relative or absolute benzodiazepine overdose.
Excessive volatile use: This is a common cause of hypoventilation and apnoea. Maintain IPPV (not excessively, as this will reduce PCO2) to allow washout to occur.