Cardiovascular safety of cocaine anaesthesia in the presence of adrenaline during septal surgery

Abstract

Objective: The purpose of this study was to investigate the possible cardiovascular side effects of 4% cocaine solution in the presence of adrenaline during septal surgery. Method: Sixty adult patients undergoing elective septal surgery with local anaesthesia were included in the study. Noses were packed with 5-mL 4% cocaine (200-mg) solution on cotton pledgets, which were left in the nose for 15 minutes. Then, 10 mL of local anaesthetic (lidocaine 2% and adrenaline 1:100,000) were infiltrated in septal mucosa, and 15 minutes later, the surgical procedure was initiated. At the beginning of the operation, intervals from 12-lead surface electrocardiograms and vital signs including blood pressures and heart rate were recorded as a baseline. All measurements were repeated just before local anaesthetic infiltration, just before the beginning of the surgical procedure, and, finally, at the end of the operation. All four measurements and electrocardiographic tracings were examined. Systolic and diastolic blood pressures and QT parameters, RR intervals, and heart rates obtained from electrocardiogram were compared statistically with repeated-measures analysis of variance. Results: No statistically significant difference was found among all four staged measurements. None of the patients developed tachycardia, hypertension, hypotension, or any chest pain. In electrocardiogram tracings, no sinus tachycardia depression, elevation, or bundle branch block was noted. Conclusion: This study shows that concomitant use of cocaine and adrenaline in the proper concentration and volume and in a carefully screened patient group was safe for the cardiovascular system.