Cocaine absorption after application of a viscous cocaine-containing TAC solution

We sought to measure plasma cocaine and benzoylecgonine levels in children after application of a solution of a topical anesthetic containing tetracaine 0.5%, epinephrine 1:2, 000, and viscous cocaine 5.9% (TAC) to lacerations requiring suture repair. Previous reports demonstrating cocaine absorption used aqueous cocaine. The purpose of this study is to determine whether systemic absorption occurs with viscous cocaine.

We used a convenience sample of children in a pediatric emergency department during the summer months of 1994 and 1995. Participants were pediatric patients less than 15 years of age with simple lacerations requiring suturing.

Twenty-five patients were enrolled in the study. The mean age of the patients was 8.5 years (range, 3 to 13 years). Lacerations tended to be small, with a mean length of 2.2 cm (range, 1 to 8 cm). Plasma cocaine and benzoylecgonine levels were measured by means of high-performance liquid chromatography. The mean time for obtaining the plasma sample for cocaine analysis was 67.2+/-23.9 minutes (range, 28 to 130 minutes) after application of the viscous cocaine-containing TAC solution. Qualitative assay results, which were accurate to 50 ng/mL, were negative in all 25 patients for both plasma cocaine and benzoylecgonine. No child demonstrated any signs or symptoms suggestive of cocaine toxicity.

In our study, application of viscous cocaine-containing TAC solutions to small lacerations did not produce clinically important cocaine absorption.