Coma due to fentanyl transdermal patches

Abstract

A 75-year-old male patient self-medicated with 1 to 1.5 patches of transdermal fentanyl patches (4.2 mg-6.3 mg) for abdominal pain of postoperative gastric cancer about half a month. In recent half a month, he gradually developed somnolence and fatigue. At night before the day the patient was admitted, he received 1.5 patches of transdermal fentanyl patches before sleep for severe abdomen pain. On the second day morning, the patient′s family members found that he developed coma and had no response to voice stimuli. Then he was admitted to emergency department. After cerebrovascular accident was excluded, treatments such as oxygen inhalation and improving blood flow etc. were given. Two days later, the patient regained consciousness gradually (the transdermal fentanyl patch before admission was removed after 72 h of treatment). The patient received another patch of transdermal fentanyl patch for abdominal pain again following the doctor′s advice and 3 h later, coma recurred. It was considered that coma was induced by transdermal fentanyl patches. The transdermal fentanyl patch was removed immediately and oxygen inhalation, IV infusion of naloxone were given. Two hours later, he regained consciousness. Key words: Fentanyl; Coma