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Current practices of cocaine administration by UK otorhinolaryngologists

Published online by Cambridge University Press:  08 March 2006

R. De ,
H. S. Uppal ,
Z. P. Shehab ,
A. W. Hilger ,
P. S. Wilson  and
R. Courteney-Harris
R. De
Affiliation:
Department of Otolaryngology, University Hospital, Birmingham, UK
H. S. Uppal
Affiliation:
Department of Otolaryngology, University Hospital, Birmingham, UK
Z. P. Shehab
Affiliation:
Department of Otolaryngology, University Hospital, Birmingham, UK
A. W. Hilger
Affiliation:
Department of Otolaryngology, University Hospital, Birmingham, UK
P. S. Wilson
Affiliation:
Department of Otolaryngology, University Hospital, Birmingham, UK
R. Courteney-Harris
Affiliation:
Department of Otolaryngology, University Hospital, Birmingham, UK
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Abstract

The aim of this study was to determine which anaesthetic and vasoconstrictor preparations UK Otorhinolaryngologists use for rhinological surgery, with particular reference to cocaine and adrenaline. The incidence and types of adverse reactions to cocaine were also recorded.

A postal survey of all BAO-HNS consultant members was performed. Of the 360 consultant surgeons included in the survey, the majority still use peri-operative cocaine on a regular basis, 66 per cent use cocaine and adrenaline together and more than 40 per cent use cocaine in paediatric patients. Sixteen per cent of respondents did not use cocaine. Only 11 per cent of surgeons had experienced cocaine toxicity in their patients, with only one recorded case of mortality.

Most surgeons in the UK use cocaine because of the superior operative field it provides and because they consider it to be safe even with adrenaline. The actual incidence of adverse reactions to cocaine is low, with serious complications being less common than the risks from general anaesthesia. Cocaine remains a valuable agent in the armamentarium of the rhinologist.

Keywords

CocaineLocal AnaestheticVasoconstrictionNoseSurgical ProceduresOperative
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 117 , Issue 2 , February 2003 , pp. 109 - 112
Copyright
© Royal Society of Medicine Press Limited 2003

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