Carbon Dioxide Narcosis

To the Editor.—In the article by Dr. Yanagisawa and me in the February 1968Archives(87:165) entitled "Carbon Dioxide Narcosis," we described an unusual complication of postnasal packing. It has been brought to our attention that this is a clinical impression and that further evidence by blood gas studies should be used to substantiate our opinions. Recently we have treated another patient with a clinical history similar to the one reported in the paper. This patient was a 74-year-old man with a metastatic renal cell carcinoma in the nasopharynx which required bilateral posterior nasal packing to control hemorrhage. Thirty-six hours postpacking, the patient developed marked edema and progressive obstruction of the upper airway. It was elected to do a tracheotomy for relief of this obstruction, but prior to and following tracheotomy arterial blood gas studies were obtained. The preoperative values were: PO2, 132; O2saturation, 96.6%;