Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cocaine is commonly used in ENT practice for its vasoconstrictor and anaesthetic properties. It is sometimes combined with adrenaline. The laser Doppler Flowmeter was used to compare the effect of 5 per cent cocaine alone or with adrenaline (1 in 1,000) on nasal mucosal blood flow. The results show an average fall in blood flow of 76.7 per cent for cocaine with adrenaline, compared to 61.2 per cent with cocaine alone. The difference is significant (P less than 0.05). The time taken for the blood flow to fall was an average of 131 s and 160 s respectively. These differences are not significant.
 ...
PMID:Comparison of cocaine alone or with adrenaline on nasal mucosal blood flow. 183 46

The total amount of cocaine used by ENT departments in the United Kingdom is about 960 kg. per year and this costs the Health Service in this country over 100,000 pounds. The majority of this cocaine is used intranasally prior to or during surgical procedures to provide mucosal vasoconstriction and analgesia. The techniques of applying cocaine vary from hospital to hospital. A comparison is made between two common methods of use, Moffett's solution and method, and 25 per cent cocaine paste applied on a wire and cotton wool probe. Cocaine serum levels were monitored and compared to known toxic dose levels.
 ...
PMID:Intranasal topical cocaine: Moffett's method or topical cocaine paste? 395 Apr 96

With increasing drug abuse of cocaine, the chances are growing that an anaesthetist comes into contact with an acutely intoxicated patient or chronic cocaine user while on call or during his daily routine. In South America chewing coca leaves is daily practise, while in the industrialised world the drug is sniffed, smoked or injected intravenously. Clinically, cocaine is used topically in ENT and ophthalmology due to its local analgesic and strong vasoconstrictive properties. Cocaine has a similar effect on the CNS as amphetamines and produces euphoria and hallucinations. Cocaine acts indirectly on sympathetic stimulation, release of dopamine and inhibition of catecholamine metabolism. It is metabolised in the liver and by serum esterases. Intoxication with cocaine leads to respiratory depression, arrhythmias, ventricular fibrillation and death. If an emergency operation during acute cocaine intoxication is necessary, all sympathomimetic anaesthetic drugs must be avoided. A deep anaesthesia must be provided to reduce the risk of cardiovascular complications. In the literature, anaesthesia is regarded as safe for patients with chronic cocaine misuse after abstinence of 24 hours. This case report shows that, even without acute intoxication, severe cardiovascular problems are possible in patients with chronic cocaine abuse. Hence, we recommend a cocaine-free interval of at least one week before elective surgical procedures.
 ...
PMID:[Intraoperative ventricular fibrillation in a patient with chronic cocaine abuse--a case report]. 1503

Cocaine is a very potent vasoconstrictor that is used by ENT specialists to reduce blood loss and enhance visibility during nasal surgery. In orthognathic surgery, especially Le Fort I procedures, excessive blood loss is a relatively frequent complication. In this study, a prospective randomized clinical trial on the effect on blood loss of cocaine/adrenaline application to the nasal floor is presented. Thirty patients who underwent a Le Fort I procedure were randomized for cocaine/adrenaline application. Blood loss and duration of surgery were registered for both groups. The results showed a significant reduction of blood loss in the group with cocaine/adrenaline application (P<0.001), but no significant difference in operating time. No side effects were observed. From this study, it can be concluded that the application of cocaine/adrenaline to the nasal floor is a safe procedure to reduce blood loss during a Le Fort I procedure.
 ...
PMID:The effect of nasal application of cocaine/adrenaline on blood loss in Le Fort I osteotomies. 1782 60