A Preliminary Study of Cocaine Absorption From the Nasal Mucosa

@article{Liao1999APS,
  title={A Preliminary Study of Cocaine Absorption From the Nasal Mucosa},
  author={B. S. Liao and Raymond L. Hilsinger and Barry M. Rasgon and Kei Matsuoka and Kedar Karim Adour},
  journal={The Laryngoscope},
  year={1999},
  volume={109}
}
Objective/Hypothesis: To determine factors affecting the safe use of topical cocaine for anesthesia and vasoconstriction during rhinologic surgery. Study Design: Prospective, randomized study of the kinetics of cocaine absorption through human nasal mucosa in 12 consecutive patients without nasal mucosal disease who were having septoplasty or septorhinoplasty. Methods: With patients under general anesthesia, cocaine was applied topically to each nasal cavity by using cottonoid pledgets. Group I… 

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Results indicate that less than 37% of cocaine is absorbed from cotton pledgets during nasal surgery, and the cocaine dose used by many otolaryngologists, did not result in significant plasma levels.

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A controlled scientific study is urgently needed to elucidate experimental data regarding the toxicity of cocaine in clinically useful doses and establish 200 mg as the safe limit for cocaine.

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Familiarity with the pharmacology of cocaine is essential for its safe application in otolaryngology, and the recommended total dose for most adult procedures is 200 to 300 mg of cocaine.

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Familiarity with the pharmacology of cocaine is essential for its safe application in otolaryngology, and the recommended total dose for most adult procedures is 200 to 300 mg of cocaine.

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TLDR
Cocaine serum levels were monitored and compared to known toxic dose levels, and a comparison is made between two common methods of use, Moffett's solution and method, and 25% cocaine paste applied on a wire and cotton wool probe.

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TLDR
In that residual cocaine was detectable on the nasal mucosa for 3 hours, continuous absorption secondary to its vasoconstrictive action might explain its persistence in the plasma.

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TLDR
In that residual cocaine was detectable on the nasal mucosa for 3 hours, continuous absorption secondary to its vasoconstrictive action might explain its persistence in the plasma.

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The mechanism of drug reactions which may give rise to hypertensive crises and may be responsible for serious complications or death in patients undergoing minor surgery under local anesthesia are described and knowledge of these interactions will be helpful in preventing serious mishaps.