The final unscheduled admission involved a patient with a history of opiate abuse and posttraumatic stress disorder that was not elucidated until after surgery. Although the patient's surgery was uneventful, he had marked postoperative pain and anxiety that required patient-controlled analgesia, methadone hydrochloride, and zolpidem tartrate. During the evening, approximately 18 hours after surgery, he experienced an apneic episode that required bag-mask ventilation and naloxone hydrochloride administration. The patient recovered completely and was not intubated. However, this case illustrates the importance of obtaining a thorough clinical history and the potential complications from oversedation. Indeed, it has been shown that most avoidable deaths after office-based surgery result from oversedation and inadequate monitoring.3 The current case also highlights the need to have transfer and emergency protocols in place. Finally, presurgical consultation with the pain management service and/or injection of the surgical sites with bupivacaine hydrochloride at the conclusion of the procedure may have been prudent.