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Does cocaine still have a role in nasal surgery?
1Department of Anaesthesiology, Johannes Gutenberg School of Medicine, Mainz, Germany.
Drug Safety
|February 6, 1999
Summary
Cocaine is no longer recommended for endonasal sinus surgery anesthesia due to severe toxic reactions. Safer alternatives like lidocaine and tetracaine with vasoconstrictors are now preferred for topical and infiltration anesthesia.
Area of Science:
- Otolaryngology
- Anesthesiology
- Pharmacology
Background:
- Endonasal sinus surgery is a prevalent and increasingly important surgical procedure.
- Effective anesthesia is crucial for successful outcomes in endonasal sinus surgery.
- Cocaine has been a preferred agent for topical and infiltration anesthesia in this context.
Purpose of the Study:
- To evaluate the safety and efficacy of cocaine as an anesthetic agent in endonasal sinus surgery.
- To explore and recommend safer alternatives to cocaine for anesthesia in endonasal sinus surgery.
Main Methods:
- Review of existing evidence regarding the toxic reactions associated with cocaine use.
- Identification and comparison of alternative anesthetic agents for topical and infiltration anesthesia.
Main Results:
- Cocaine use, even by experienced surgeons, can lead to rapid, unexpected, and severe toxic reactions.
- Safer and well-tolerated alternatives for topical and infiltration anesthesia are readily available.
Conclusions:
- The use of cocaine for anesthesia in endonasal sinus surgery is no longer advisable.
- Recommended alternatives include lidocaine or tetracaine combined with vasoconstrictors like epinephrine, naphazoline, or oxymetazoline.