Combination is still widely used

BMJ 1995;311:1089 (21 October)

Letters

Combination is still widely used

EDITOR,--The use of cocaine and adrenaline paste is a controversialissue among otolaryngologists.¹ In 1991 the British Associationof Otolaryngologists--Head and Neck Surgeons surveyed all consultantsurgeons who were members and found that 63.5% used cocainewithout adrenaline, 19.5% used cocaine and adrenaline, and 17%used cocaine with and without adrenaline.² Of the 312 who usedcocaine, 76 had changed their method of using it since 1986,generally because of concern about safety. Six deaths were recordedin the report.

The British National Formulary states that "cocaine is stillused in otolaryngology and is applied to the nasal mucosa inconcentrations of 4 to 10% (40-100 mg/ml). The maximum totaldose recommended for application to the nasal mucosa in fitadults is a total of 1.5 mg/kg, which is equivalent to a totaltopical dose of approximately 100 mg for an adult male. It shouldbe used only by those . . . [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]