Hashisaki G T, Johns M E
Contemp Anesth Pract. 1987;9:31-45.
Cocaine applied by knowledgeable otolaryngologists is an excellent topical anesthetic agent. For procedures of the upper respiratory tract, it is unrivaled by the synthetic anesthetics. It possesses a short latency, an adequate duration of action, and a valuable inherent vasoconstrictive capability. To prevent accidental injection of cocaine solutions, we recommend that the solutions be colored by the pharmacy. Our recommended total dose for most adult procedures is 200 to 300 mg of cocaine. In the uncommon case in which this amount may be inadequate, injections of lidocaine with dilute epinephrine can be used to supplement the cocaine. To prevent overdosing, we recommend starting with a known amount, recording the amount given, and not exceeding this total dose. Familiarity with the pharmacology of cocaine is essential for its safe application in otolaryngology.
知识渊博的耳鼻喉科医生使用的可卡因是一种极好的局部麻醉剂。在上呼吸道手术中，它是合成麻醉剂无法比拟的。它起效潜伏期短，作用持续时间足够，并且具有宝贵的内在血管收缩能力。为防止意外注射可卡因溶液，我们建议药房给溶液上色。对于大多数成人手术，我们推荐的可卡因总剂量为200至300毫克。在极少数情况下，这个剂量可能不足，可以使用利多卡因加稀释肾上腺素注射液来补充可卡因。为防止用药过量，我们建议从已知剂量开始，记录给药量，且不要超过这个总剂量。熟悉可卡因的药理学对于其在耳鼻喉科的安全应用至关重要。
