Cocaine absorption after application of a viscous cocaine-containing TAC solution.
OBJECTIVE
We sought to measure plasma cocaine and benzoylecgonine levels in children after application of a solution of a topical anesthetic containing tetracaine 0.5%, epinephrine 1:2, 000, and viscous cocaine 5.9% (TAC) to lacerations requiring suture repair. Previous reports demonstrating cocaine absorption used aqueous cocaine. The purpose of this study is to determine whether systemic absorption occurs with viscous cocaine.


METHODS
We used a convenience sample of children in a pediatric emergency department during the summer months of 1994 and 1995. Participants were pediatric patients less than 15 years of age with simple lacerations requiring suturing.


RESULTS
Twenty-five patients were enrolled in the study. The mean age of the patients was 8.5 years (range, 3 to 13 years). Lacerations tended to be small, with a mean length of 2.2 cm (range, 1 to 8 cm). Plasma cocaine and benzoylecgonine levels were measured by means of high-performance liquid chromatography. The mean time for obtaining the plasma sample for cocaine analysis was 67.2+/-23.9 minutes (range, 28 to 130 minutes) after application of the viscous cocaine-containing TAC solution. Qualitative assay results, which were accurate to 50 ng/mL, were negative in all 25 patients for both plasma cocaine and benzoylecgonine. No child demonstrated any signs or symptoms suggestive of cocaine toxicity.


CONCLUSIONS
In our study, application of viscous cocaine-containing TAC solutions to small lacerations did not produce clinically important cocaine absorption.
Vinci
R J
RJ
Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA. bob.vinci@bmc.org
Fish
S
S
Mirochnick
M
M
D000293:Adolescent; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D002648:Child; D002675:Child, Preschool; D003042:Cocaine / Q000031:analogs & derivatives / Q000097:blood*; D004837:Epinephrine; D005260:Female; D006801:Humans; D008297:Male; D012869:Skin Absorption; D013748:Tetracaine
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D013748:Tetracaine; C005618:benzoylecgonine; C034627:TEC solution; D003042:Cocaine; D004837:Epinephrine