Cocaine toxicity during dacryocystorhinostomy
E. F. Meyers
Toxic effects were observed in two healthy patients who received cocaine
intranasally before dacryocystorhinostomy. One patient suffered an
additional reaction to intranasally administered phenylephrine
(Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of
catecholamines and has a sympathetic potentiating effect, its use is
dangerous in patients with hypertensive cardiovascular disease or in
conjunction with sympathomimetic or alpha-modifying drugs. Use of dilute
solutions carefully measured for select patients is mandatory. The total
dose of cocaine should not exceed 3 mg/kg.
