Fitzmaurice L S, Wasserman G S, Knapp J F, Roberts D K, Waeckerle J F, Fox M
Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri.
Ann Emerg Med. 1990 May;19(5):515-8. doi: 10.1016/s0196-0644(05)82180-8.
The topical anesthetic TAC (tetracaine 0.5%, adrenaline 0.05%, cocaine 11.8%) has been reported to be effective in pain control for local procedures. However, it has the potential for cocaine toxicity by absorption through an open wound. A study was undertaken to assess the systemic absorption of cocaine and its metabolites when TAC is used as a local anesthetic. Fifty-one children, 1 to 14 years of age, were enrolled in the study. Plasma for cocaine and/or its metabolite levels was available from 46 children and obtained 20 to 40 minutes after the topical anesthetic was applied. No plasma sample had detectable parent cocaine levels; however, 26 (56.5%) had cocaine metabolite levels. Ecgonine methylester levels were detected in plasma from six children and ranged from 59 to 985 ng/mL. Benzoylecgonine levels were detected in none of 19 specimens not preserved with sodium fluoride, and in 23 of 27 specimens to which sodium fluoride had been added. Benzoylecgonine levels ranged from 40 to more than 600 ng/mL. No clinical sign of cocaine toxicity was observed in any child.
据报道，局部麻醉剂TAC（丁卡因0.5%、肾上腺素0.05%、可卡因11.8%）在局部手术的疼痛控制方面有效。然而，它有可能通过开放性伤口吸收而导致可卡因中毒。开展了一项研究，以评估将TAC用作局部麻醉剂时可卡因及其代谢物的全身吸收情况。51名1至14岁的儿童参与了该研究。46名儿童可获取可卡因和/或其代谢物水平的血浆样本，这些样本在涂抹局部麻醉剂后20至40分钟采集。没有血浆样本检测到可卡因母体水平；然而，26名（56.5%）儿童有可卡因代谢物水平。在6名儿童的血浆中检测到了芽子碱甲酯水平，范围为59至985纳克/毫升。在19份未用氟化钠保存的样本中均未检测到苯甲酰爱康宁水平，而在添加了氟化钠的27份样本中的23份中检测到了苯甲酰爱康宁水平。苯甲酰爱康宁水平范围为40至超过600纳克/毫升。未在任何儿童中观察到可卡因中毒的临床症状。
