Key result
Topical cocaine and epinephrine trigger ventricular fibrillation during septoplasty, followed by successful resuscitation.
Why the study?
The cardiac risk of combined administration of cocaine and epinephrine during general anesthesia is not well characterized.
Case Report (n=1)
Alerts clinicians to VF risk with topical cocaine-epinephrine; this Level 5 case leaves open broader safety questions.
We report the case of a 17-year-old female patient, scheduled for septoplasty under general anesthesia, who developed ventricular fibrillation after intranasal application of cocaine (350 mg) and submucosal injection of lidocaine (20 mg) with epinephrine (100 micrograms). Resuscitation by external chest compression was successful, and normal sinus rhythm was reestablished after lidocaine injection (50 mg, i.v.). The cardiac risk of the combined administration of cocaine and epinephrine during general anesthesia are discussed.
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Lormans et al. (2010) conducted a case report in Ventricular Fibrillation (n=1). Intranasal cocaine and submucosal lidocaine with epinephrine was evaluated on Ventricular fibrillation and successful resuscitation. Local application of cocaine (350 mg) and epinephrine (100 mcg) induced ventricular fibrillation in a 17-year-old female undergoing septoplasty, who was successfully resuscitated.