Vinci R J, Fish S, Mirochnick M
Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
Ann Emerg Med. 1999 Oct;34(4 Pt 1):498-502. doi: 10.1016/s0196-0644(99)80052-3.
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.
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.
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.
In our study, application of viscous cocaine-containing TAC solutions to small lacerations did not produce clinically important cocaine absorption.
我们试图测量在给需要缝合修复的裂伤处涂抹含有0.5%丁卡因、1:2000肾上腺素和5.9%粘性可卡因（TAC）的局部麻醉溶液后儿童血浆中可卡因和苯甲酰爱康宁的水平。既往关于可卡因吸收的报告使用的是水性可卡因。本研究的目的是确定粘性可卡因是否会发生全身吸收。
我们选取了1994年和1995年夏季儿科急诊科的儿童作为便利样本。参与者为年龄小于15岁、有简单裂伤需要缝合的儿科患者。
25名患者纳入研究。患者的平均年龄为8.5岁（范围3至13岁）。裂伤往往较小，平均长度为2.2厘米（范围1至8厘米）。采用高效液相色谱法测量血浆可卡因和苯甲酰爱康宁水平。在涂抹含粘性可卡因的TAC溶液后，获取用于可卡因分析的血浆样本的平均时间为67.2±23.9分钟（范围28至130分钟）。定性检测结果精确到50纳克/毫升，25名患者的血浆可卡因和苯甲酰爱康宁检测结果均为阴性。没有儿童表现出任何提示可卡因毒性的体征或症状。
在我们的研究中，给小裂伤处涂抹含粘性可卡因的TAC溶液未产生具有临床意义的可卡因吸收。
