Cardiac complication from use of cocaine and phenylephrine in nasal septoplasty

• Published in: Archives of otolaryngology--head & neck surgery Vol. 121; no. 6; p. 681
• Main Authors: Ashchi, M, Wiedemann, H P, James, K B
• Format: Journal Article
• Language: English
• Published: United States 01-06-1995
• Subjects: Administration, Topical; Adult; Anesthesia, Local - adverse effects; Cocaine - administration & dosage; Cocaine - adverse effects; Elective Surgical Procedures; Female; Humans; Male; Middle Aged; Myocardial Infarction - chemically induced; Myocardial Stunning - chemically induced; Nasal Septum - surgery; Phenylephrine - administration & dosage; Phenylephrine - adverse effects
• ISSN: 0886-4470
• DOI: 10.1001/archotol.1995.01890060079016

Cocaine hydrochloride is widely used as a topical anesthetic for otolaryngologic surgery. Cardiovascular complications, including myocardial injury, are well-documented side effects of illicit cocaine use. We describe a 23-year-old woman without coronary artery disease who had an acute non-Q-wave myocardial infarction and stunned myocardium after receiving topical phenylephrine hydrochloride and cocaine anesthesia for elective nasal septoplasty. These cases are rare; however, we hope to heighten the awareness of the potential lethal complications of using cocaine, phenylephrine, or the combination of both as topical anesthetics in otolaryngologic practice.