Cardiovascular safety of cocaine anaesthesia in the presence of adrenalineduring septal surgery

Objective: The purpose of this study was to investigate the possible cardio vascular side effects of 4% cocaine solution in the presence of adrenaline during septal surgery. Method: Sixty adult patients undergoing elective septal surgery with local anaesthesia were included in the study. Noses were packed with 5-mL 4% coca ine (200-mg) solution on cotton pledgets, which were left in the nose for 1 5 minutes. Then, 10 mt of local anaesthetic (lidocaine 2% and adrenaline 1: 100,000) were infiltrated in septal mucosa, and 15 minutes later, the surgi cal procedure was initiated. At the beginning of the operation, intervals f rom 12-lead surface electrocardiograms and vital signs including blood pres sures and heart rate were recorded as a baseline. All measurements were rep eated just before local anaesthetic infiltration, just before the beginning of the surgical procedure, and, finally, at the end of the operation. All four measurements and electrocardiographic tracings were examined. Systolic and diastolic blood pressures and QT parameters, RR intervals, and heart r ates obtained from electrocardiogram were compared statistically with repea ted-measures analysis of variance. Results: No statistically significant difference was found among all four s taged measurements. None of the patients developed tachycardia, hypertensio n, hypotension, or any chest pain. In electrocardiogram tracings, no sinus tachycardia depression, elevation, or bundle branch block was noted. Conclusion: This study shows that concomitant use of cocaine and adrenaline in the proper concentration and volume and in a carefully screened patient group was safe for the cardiovascular system.