ANALYSIS OF THE COCAINE METABOLITE IN THE URINE OF PATIENTS AND PHYSICIANS DURING CLINICAL USE

Cocaine is considered a superb anesthetic for many otolaryngologic pro cedures and has been shown to be positive in the urine of patients for up to 72 hours after surgery with a standard radioimmunoassay test. T he standard cutoff for drug screening of benzoylecgonine, the main uri ne metabolite of cocaine, has been 300 ng/ml. However, the new thresho ld value in many laboratories is now 150 ng/ml. In review of the liter ature, no study has been performed that quantitates the actual level o f the urine cocaine metabolite after a routine otolaryngologic procedu re in both physicians and their patients with the gold standard for ur ine testing, gas chromatography. This study documents the quantitative level of the urine cocaine metabolite in patients and reveals that th ere are metabolite levels present in physicians during a single exposu re, although they are below the current cutoff level that will be pick ed up on current screening assays. Evidence has also been presented de monstrating a cumulative effect on the benzoylecgonine levels in physi cians who clinically use cocaine anesthesia more frequently; these lev els can be above the cutoff level on current screening assays.