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Cocaine uses and abuses.

D N Fairbanks, G R Fairbanks

    Annals of Plastic Surgery
    |June 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Cocaine provides effective anesthesia and nasal vasoconstriction for surgery, but carries risks. Central nervous system excitability and cardiovascular toxicity are key concerns, manageable with diazepam.

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    Area of Science:

    • Anesthesiology
    • Pharmacology
    • Otolaryngology

    Background:

    • Cocaine is a historically used topical anesthetic in intranasal surgery.
    • It offers anesthesia, vasoconstriction, and euphoria, improving surgical conditions and patient tolerance.

    Observation:

    • Standard surgical doses (200 mg) are generally safe and effective.
    • The primary toxic reaction is central nervous system excitability, potentially leading to seizures and apnea.
    • Cardiovascular toxicity may occur with higher doses or concurrent epinephrine use.

    Findings:

    • Intravenous diazepam can prevent cocaine-induced central nervous system excitability.
    • Cocaine's vasoconstrictive and irritant properties can damage nasal tissues and septal cartilage.
    • Psychological effects include stimulation, with potential for paranoia and violent behavior in prolonged recreational use.

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    Implications:

    • Safe anesthetic use requires careful dosage monitoring and preparedness for managing CNS toxicity.
    • The detrimental effects on nasal structures necessitate consideration of alternative agents or techniques.
    • Understanding the psychological risks is crucial for addressing recreational abuse and its severe consequences.