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BJA Advance Access published online on August 16, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael221
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted July 3, 2006

Clinical Investigation

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

G. E. Hill 1 *, B. O. Ogunnaike 1, and E. R. Johnson 1

1 Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9068, USA

* To whom correspondence should be addressed.
G. E. Hill, E-mail: gary.hill{at}utsouthwestern.edu


  Abstract

Background. Commonly, cocaine abusing patient are scheduled for elective surgery with a positive urine test for cocaine metabolites. As many of these patients were clinically non-toxic [normal arterial pressure and heart rate, normothermic, and a normal (or unchanged from previous) ECG, including a QTc interval <500 ms], we have recently proceeded with elective surgery requiring general anaesthesia in this patient group.

Methods. Forty urine cocaine positive patients were compared with an equal number of drug-free controls in a prospective, non-randomized, blinded analysis. Intraoperative mean arterial blood pressure, ST segment analysis, heart rate and body temperature were recorded and compared.

Results. 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.

Conclusions. These results demonstrate that the non-toxic cocaine abusing patient can be administered general anaesthesia with no greater risk than comparable age and ASA matched drug-free patients.

Keywords: anaesthesia, general; anaesthetics local, cocaine; complications, adverse events; QTc interval.
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