Cocaine: what role does it have in current ENT practice? A review of the current literature

  title={Cocaine: what role does it have in current ENT practice? A review of the current literature},
  author={Stephen Harper and Nick S. Jones},
  journal={The Journal of Laryngology \& Otology},
  pages={808 - 811}
  • S. HarperN. Jones
  • Published 19 July 2006
  • Medicine
  • The Journal of Laryngology & Otology
Topical cocaine is used by many otorhinolaryngologists because of its good local anaesthetic and vasoconstrictive properties. A review of the available literature suggests a risk/benefit analysis would suggest that in the out-patient setting local anaesthetic agents which do not contain cocaine should be used. For rhinosurgical procedures, preparations containing cocaine and adrenaline in the appropriate concentrations and doseage are safe in the vast majority of patients without previous… 

Care of the Cocaine User with Nasal Deformity

A practical evidence‐based guide to management of reconstruction of the cocaine nose, taking in all aspects of periprocedural care and a model for surgical approach based on best evidence and the experience of the senior author are presented.

Patient perceptions of the use of cocaine in sinonasal surgery

A solution of cocaine, adrenaline and sodium bicarbonate is eponymously termed Moffett's, which increases the anaesthetic properties while having no effect on toxicity.

Cocaine detection in postmortem samples following therapeutic administration.

It is important to note that the presence of cocaine and its metabolites in forensic samples cannot always be attributed to abuse and that a thorough investigation and review of medical records is warranted before an informed conclusion can be made.

General anaesthesia for the cocaine abusing patient. Is it safe?

Cardiovascular stability during and after general anaesthesia in cocaine positive, non-toxic patients was not significantly different when compared with an age and ASA matched drug-free control group.

Hemostasis in sinus surgery

  • Y. ZhaoA. Psaltis
  • Medicine
    Current opinion in otolaryngology & head and neck surgery
  • 2016
Improved standardization of scoring and reporting of bleeding may increase the power of research studies to draw more definitive conclusions about the role that certain factors have on hemostasis.

Concerns for I l l ic it and Prescription Drug Use

Care must be taken to ensure exposure to offending agents has ceased before attempting repair and consequently, otolaryngologists may insist on drug testing before proceeding to surgery.

Systemic Pharmacokinetics of Topical Intranasal Cocaine in Healthy Subjects

Only 4% of the administered cocaine dose appeared to be absorbed in this study, and cocaine appeared in the urine with a time course similar to that in plasma.

Otolaryngology Concerns for Illicit and Prescription Drug Use.



Cocaine use by the otolaryngologist: a survey.

  • M. JohnsR. Henderson
  • Medicine
    Transactions. Section on Otolaryngology. American Academy of Ophthalmology and Otolaryngology
  • 1977
A controlled scientific study to elucidate experimental data regarding the toxicity of cocaine in clinically useful doses is urgently needed.

Cocaine use by the otolaryngologist: a survey.

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.

The clinical use of cocaine.

Current practices of cocaine administration by UK otorhinolaryngologists

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, with serious complications being less common than the risks from general anaesthesia.

Lesson of the Week: Cocaine and adrenaline paste: a fatal combination?

Cocaine and adrenaline paste is most commonly used by otorhinolaryngologists for operations on the nose, including rhinoplasty and submucous resection and is an effective topical anaesthetic with an intense vasoconstrictor action that facilitates surgery and improves haemostasis.

Cocaine and adrenaline: a safe or necessary combination in the nose? A study to determine the effect of adrenaline on the absorption and adverse side effects of cocaine.

It is concluded that adrenaline can still be a valuable as well as safe addition to topical cocaine used in the nose.

Topical Cocaine/Adrenaline Combination in Intransal Surgery — is it Necessary?

The conclusion is that the Adrenaline/Cocaine mixture has no advantage and its potentially dangerous interaction makes it unnecessary and unjustified.

Lignocaine with adrenaline: is it as effective as cocaine in rhinological practice?

It is concluded from this study that 4% lignocaine with adrenaline (1:1000) solution is as effective as 10% cocaine.

Narcotic septal perforations due to drug addiction.

Most individuals have a rather vague and sometimes erroneous idea of the actual incidence of this complication, which was first brought to the author's attention in 1952 when he conferred with the late Dr. Lichtenstein about a case of narcotic septal perforation due to heroin.

Sinonasal Osteocartilaginous Necrosis in Cocaine Abusers: Experience in 25 Patients

Any sinonasal inflammation involving the midline that persists or remains refractory to treatment may be the first manifestation of potentially lethal drug addiction.