Parameters for treatment of cocaine-positive patients.
OBJECTIVE
The purpose of this study was to identify the parameters by which oral and maxillofacial surgeons and anesthesiologists make decisions as to the safety for proceeding with surgery and anesthesia in cocaine-positive patients and to determine a national consensus of opinion, if possible.


METHODS
Questionnaires were mailed to all known oral and maxillofacial surgery training programs and anesthesiology training programs in the United States (n = 241). Programs were queried as to screening, testing, parameters, and outcomes.


RESULTS
Of the 241 questionnaires mailed, 114 (47%) were returned. Identification on the returns was optional; therefore, it was impossible to determine the total from each discipline. Only 16% of the programs had a formalized policy for cocaine screening prior to surgery and anesthesia. There was significant variability in the length of delay/time lapse before proceeding with anesthesia and surgery in the face of cocaine positivity.


CONCLUSIONS
Based on the returned questionnaires and literature searches, the authors propose that patients who test positive for cocaine in their urine may undergo necessary surgical and anesthetic care, after an 8-hour period of discontinuing of cocaine, if the individual is hemodynamically stable.
Granite
Edwin L
EL
Department of Oral and Maxillofacial Surgery, Christiana Care Health System, Wilmington Hospital, Wilmington, DE 19801, USA. egranite@christianacare.org
Farber
Neil J
NJ
Adler
Pablo
P
D000328:Adult; D000758:Anesthesia; D003042:Cocaine / Q000652:urine; D019970:Cocaine-Related Disorders / Q000150:complications*; D000075202:Contraindications; D003657:Decision Making; D004347:Drug Interactions; D005151:Facial Injuries / Q000150:complications / Q000628:therapy; D006801:Humans; D019647:Oral Surgical Procedures; D019990:Perioperative Care / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D016079:Refusal to Treat / Q000706:statistics & numerical data; D015813:Substance Abuse Detection / Q000706:statistics & numerical data*; D013997:Time Factors; D014481:United States
D003042:Cocaine