General anaesthesia for the cocaine abusing patient. Is it safe?

Background. Commonly, cocaine abusing patient are scheduled for elective surgery with a positive urine test for cocaine metabolites. As many of these patients were clinically non-toxic [normal arterial pressure and heart rate, normothermic, and a normal (or unchanged from previous) ECG, including a QTc interval <500 ms], we have recently proceeded with elective surgery requiring general anaesthesia in this patient group. Methods. Forty urine cocaine positive patients were compared with an equal number of drug-free controls in a prospective, non-randomized, blinded analysis. Intraoperative mean arterial blood pressure, ST segment analysis, heart rate and body temperature were recorded and compared. Results. Cardiovascular stability during and after general anaesthesia in cocaine positive, non-toxic patients was not significantly different when compared with an age and ASA matched drug-free control group. Conclusions. These results demonstrate that the non-toxic cocaine abusing patient can be administered general anaesthesia with no greater risk than comparable age and ASA matched drug-free patients.