BMJ 1995;311:1089 (21 October)

Letters

Accurate measurement of dose and patience are important

EDITOR,--K E A Nicholson and J E G Rogers's lesson of the week about arrhythmias associated with the use of cocaine and adrenaline paste1 is bound to fuel the controversy surrounding the use of these two drugs in sinonasal surgery. It is unclear from their report whether the overdose of cocaine was intentional or inadvertent: all three patients reported on received two to three times the maximum recommended dose of cocaine for their weight. With no evidence of similar complications when cocaine is used in recommended doses, to abandon this drug combination in all forms seems an overreaction. Recommended maximum doses surely have a purpose. Overdose of almost any anaesthetic drug will result in death; this does not result in a generalised call for withdrawal or the drug, nor should it.

The volume of cocaine paste can be measured with a 2 ml syringe; this avoids inadvertent overdose. In at . . . [Full text of this article]


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Relevant Article

Lesson of the Week: Cocaine and adrenaline paste: a fatal combination?
K E A Nicholson and J E G Rogers
BMJ 1995 311: 250-251. [Extract] [Full Text]

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