Document Detail

The cocaine-using patient: perioperative concerns.
MedLine Citation:
PMID:  15830766     Owner:  NLM     Status:  MEDLINE    
Cocaine is an extremely addictive agent which can produce stimulation of the sympathetic nervous system due to the inhibition of catecholamine reuptake at the synaptic junction. Probability of a patient presenting to the operating theatre with acute cocaine intoxication is increasingly likely. The physiological effects of even chronic cocaine abuse on various organ systems have an impact on anesthetic management. A preoperative review of major organ systems is essential. Nitroglycerin has been used in the management of hypertension associated with coronary vasoconstriction. Controversy exists regarding management of ventricular dysrhythmias and asystole. The use of epinephrine to treat asystole is controversial in the presence of a state of excess catecholamines induced by cocaine. General anesthesia may include barbiturates, nitrous oxide, and opioids, but inhalational agents must be used with caution due to their myocardial depressant effects. Regional anesthesia may be a good choice if coagulopathies and hypovolemia are corrected.
Jonathan H Skerman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Middle East journal of anaesthesiology     Volume:  18     ISSN:  0544-0440     ISO Abbreviation:  Middle East J Anaesthesiol     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-04-15     Completed Date:  2005-05-26     Revised Date:  2014-10-10    
Medline Journal Info:
Nlm Unique ID:  8604187     Medline TA:  Middle East J Anaesthesiol     Country:  Lebanon    
Other Details:
Languages:  eng     Pagination:  107-22     Citation Subset:  IM    
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MeSH Terms
Central Nervous System Diseases / etiology
Cocaine / pharmacokinetics,  pharmacology,  toxicity
Cocaine-Related Disorders / complications*
Fetus / drug effects
Heart Diseases / etiology
Lung Diseases / etiology
Perioperative Care*
Reg. No./Substance:

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