ABSORPTION OF TOPICAL COCAINE IN RHINOLOGIC PROCEDURES

Although topical intranasal cocaine remains a common anesthetic in nas al surgery, controversy surrounds its dosage and mucosal absorption, A prospective study of 12 patients undergoing nasal surgery was perform ed to evaluate the absorption of cocaine solution from standard cotton pledgets. Of a 160-mg cocaine solution applied, a mean amount of 102 mg or 63.8% was recovered by gas chromatography/mass spectrometry anal ysis, Similar analysis of nasopharyngeal packs revealed less than 1.5% cocaine loss in the nasopharynx, Serum levels of cocaine were rarely detectable and did not correlate with either the amount of nasal absor ption or time of mucosal contact. These results indicate that less tha n 37% of cocaine is absorbed from cotton pledgets during nasal surgery . The cocaine dose of 160 mg, used by many otolaryngologists, did not result in significant plasma levels.