Parameters for Treatment of Cocaine-Positive Patients
Purpose
The purpose of this study was to identify the parameters by which oral and maxillofacial surgeons and anesthesiologists make decisions as to the safety for proceeding with surgery and anesthesia in cocaine-positive patients and to determine a national consensus of opinion, if possible.
Methods
Questionnaires were mailed to all known oral and maxillofacial surgery training programs and anesthesiology training programs in the United States (n = 241). Programs were queried as to screening, testing, parameters, and outcomes.
Results
Of the 241 questionnaires mailed, 114 (47%) were returned. Identification on the returns was optional; therefore, it was impossible to determine the total from each discipline. Only 16% of the programs had a formalized policy for cocaine screening prior to surgery and anesthesia. There was significant variability in the length of delay/time lapse before proceeding with anesthesia and surgery in the face of cocaine positivity.
Conclusion
Based on the returned questionnaires and literature searches, the authors propose that patients who test positive for cocaine in their urine may undergo necessary surgical and anesthetic care, after an 8-hour period of discontinuing of cocaine, if the individual is hemodynamically stable.
⁎Chairman, Program Director, and Section Chief, Department of Oral and Maxillofacial Surgery, Christiana Care Health System, Wilmington Hospital, Wilmington, DE.
†Chief, General Internal Medicine Faculty, Christiana Care Health System, Christiana Hospital, Newark, DE.
‡Anesthesiologist, Physician Liaison Nurse Anesthesia Training Program, Department of Anesthesiology, Christiana Care Health System, Wilmington Hospital, Wilmington, DE.
Address correspondence and reprint requests to Dr Granite: Department of Oral and Maxillofacial Surgery, Christiana Care Health System, 501 West 14th Street, Wilmington Hospital, Wilmington, DE 19801
ABSTRACT