Chiu Y C, Brecht K, DasGupta D S, Mhoon E
Arch Otolaryngol Head Neck Surg. 1986 Sep;112(9):988-90. doi: 10.1001/archotol.1986.03780090084017.
Cocaine, the active alkaloid in coca leaf, is widely used as local anesthetic for otolaryngologic procedures. Our patient suffered an acute nontransmural myocardial infarction following clinical use of cocaine as topical anesthesia for nasal surgery, the first such case to be documented, to our knowledge. Although evidence documenting its cardiovascular toxicity is listed in contemporary pharmacologic literature, clinical cardiac injury has been reported to date only with the recreational use of cocaine. Authentic documentation of drug composition when received through the intervention of illicit vendors is always difficult. The literature is reviewed, justifying the use of cocaine as the most popular topical anesthetic in otolaryngologic practice. However, we hope that awareness of this possible complication will create a resurgence of research interest in topical cocaine anesthesia.
可卡因是古柯叶中的活性生物碱，在耳鼻喉科手术中被广泛用作局部麻醉剂。据我们所知，我们的患者在将可卡因用作鼻部手术的局部麻醉剂后发生了急性非透壁性心肌梗死，这是首例有记录的此类病例。尽管当代药理学文献中列出了证明其心血管毒性的证据，但迄今为止，仅在可卡因的娱乐性使用中报告过临床心脏损伤。通过非法供应商的干预收到的药物成分的真实记录一直很困难。本文献综述证明了可卡因在耳鼻喉科实践中作为最常用局部麻醉剂的应用。然而，我们希望对这种可能并发症的认识将重新激发对局部可卡因麻醉的研究兴趣。
