Cardiac complication from use of cocaine and phenylephrine in nasal septoplasty.
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.
Ashchi
M
M
Mount Sinai Medical Center/MetroHealth Medical Center, Cleveland, Ohio, USA.
Wiedemann
H P
HP
James
K B
KB
D000287:Administration, Topical; D000328:Adult; D000772:Anesthesia, Local / Q000009:adverse effects*; D003042:Cocaine / Q000008:administration & dosage / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced*; D017682:Myocardial Stunning / Q000139:chemically induced*; D009300:Nasal Septum / Q000601:surgery*; D010656:Phenylephrine / Q000008:administration & dosage / Q000009:adverse effects*
D010656:Phenylephrine; D003042:Cocaine