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

Abstract

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. 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. 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. 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.