Lips F J, O'Reilly J, Close D, Beaumont G D, Clapham M
Anaesth Intensive Care. 1987 May;15(2):141-6. doi: 10.1177/0310057X8701500204.
Twenty patients presenting for submucous resection of the nasal septum under general anaesthesia were randomly allocated to four groups to receive either 1.0 ml 25% cocaine HCl in paraffin paste, 1.0 ml 25% cocaine HCl combined with 0.1% adrenaline in paraffin paste, 4.0 ml aqueous 4% cocaine HCl combined with 0.05% adrenaline or 4.0 ml aqueous 4% cocaine HCl on ribbon gauze applied to the nasal mucosa. Mean intraoperative blood loss was significantly decreased when the 25% cocaine 0.1% adrenaline combination in paraffin paste was used (11 (SD 8) ml, 60 (SD 30) ml, P less than 0.05, for adrenaline and plain paste respectively). Combination of adrenaline with cocaine in the aqueous formulation was not associated with a significant decrease in blood loss compared with aqueous cocaine alone (75 (SD 51), 96 (SD 66) ml respectively). Cocaine adrenaline paste and plain cocaine paste were associated with higher mean maximum cocaine blood concentrations (1.6 (SD 1.4), 2.0 (SD 1.5) micrograms/ml respectively) when compared with aqueous cocaine adrenaline and aqueous cocaine alone (0.03 (SD 0.003), 0.5 (SD 0.3) microgram/ml respectively). Heart rate and blood pressure changes were similar in all four groups and cardiovascular toxicity was not observed. One ml of topical intranasal 25% cocaine HCl with 0.1% adrenaline in paraffin paste provided the best haemostasis for nasal septal surgery.
二十名接受全身麻醉下鼻中隔黏膜下切除术的患者被随机分为四组，分别接受以下处理：1.0毫升25%盐酸可卡因石蜡糊剂；1.0毫升25%盐酸可卡因与0.1%肾上腺素的石蜡糊剂；4.0毫升4%盐酸可卡因水溶液与0.05%肾上腺素；或4.0毫升4%盐酸可卡因水溶液涂于带状纱布上并应用于鼻黏膜。当使用含0.1%肾上腺素的25%可卡因石蜡糊剂时，术中平均失血量显著减少（分别为11（标准差8）毫升、60（标准差30）毫升，肾上腺素组和单纯石蜡糊剂组，P<0.05）。与单独使用可卡因水溶液相比，肾上腺素与可卡因的水溶液配方并未使失血量显著减少（分别为75（标准差51）、96（标准差66）毫升）。与单独的可卡因水溶液和肾上腺素与可卡因的水溶液相比，可卡因肾上腺素糊剂和单纯可卡因糊剂的平均最大可卡因血药浓度更高（分别为1.6（标准差1.4）、2.0（标准差1.5）微克/毫升，而单独的可卡因水溶液和肾上腺素与可卡因的水溶液分别为0.03（标准差0.003）、0.5（标准差0.3）微克/毫升）。四组的心率和血压变化相似，未观察到心血管毒性。1.0毫升含0.1%肾上腺素的25%盐酸可卡因鼻腔局部石蜡糊剂为鼻中隔手术提供了最佳止血效果。
