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General anaesthesia for the cocaine abusing patient. Is it safe?
G E Hill1, B O Ogunnaike, E R Johnson
1Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard, Dallas, TX 75390-9068, USA. gary.hill@utsouthwestern.edu
Background:
Commonly, cocaine abusing patient are scheduled for elective surgery with a positive urine test for cocaine metabolites. As many of these patients were clinically non-toxic [normal arterial pressure and heart rate, normothermic, and a normal (or unchanged from previous) ECG, including a QTc interval <500 ms], we have recently proceeded with elective surgery requiring general anaesthesia in this patient group.
Methods:
Forty urine cocaine positive patients were compared with an equal number of drug-free controls in a prospective, non-randomized, blinded analysis. Intraoperative mean arterial blood pressure, ST segment analysis, heart rate and body temperature were recorded and compared.
Results:
Cardiovascular stability during and after general anaesthesia in cocaine positive, non-toxic patients was not significantly different when compared with an age and ASA matched drug-free control group.
Conclusions:
These results demonstrate that the non-toxic cocaine abusing patient can be administered general anaesthesia with no greater risk than comparable age and ASA matched drug-free patients.
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