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Cocaine use in sinonasal surgery: patients’ perspective on its use and the need for pre-operative consent

Published online by Cambridge University Press:  08 May 2024

Justin Jui Yuan Yeo Open the ORCID record for Justin Jui Yuan Yeo [Opens in a new window] ,
Sharifah Sara Syed Badrol ,
Amandeep Maan ,
Jacquline Chan ,
James Barraclough  and
Suzanne Jervis
Justin Jui Yuan Yeo*
Affiliation:
Department of ENT, Russell Halls Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK
Sharifah Sara Syed Badrol
Affiliation:
Department of ENT, Russell Halls Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK Department of ENT, Princess Royal Hospital, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
Amandeep Maan
Affiliation:
Department of ENT, Russell Halls Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK
Jacquline Chan
Affiliation:
Department of ENT, Russell Halls Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK Department of ENT, Princess Royal Hospital, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
James Barraclough
Affiliation:
Department of ENT, Russell Halls Hospital, The Dudley Group NHS Foundation Trust, Dudley, UK
Suzanne Jervis
Affiliation:
Department of ENT, Princess Royal Hospital, Shrewsbury and Telford Hospital NHS Trust, Telford, UK
*
Corresponding author: Justin Jui Yuan Yeo; Email: [email protected]
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Abstract

Objectives

Intranasal cocaine is commonly used in endoscopic sinus surgery due to its vasoconstrictive and anaesthetic properties. This study aimed to understand patients’ perspectives and whether patients should have to give their consent for its use.

Methods

Prospective data were collected over a three-month period in ENT departments in the out-patient setting of two district general hospitals. An anonymous questionnaire was distributed to all adult patients asking for their thoughts on cocaine use in sinonasal surgery and the need for peri-operative discussion.

Results

In total, 123 patient questionnaires were analysed. It was found that 9.8 per cent of patients knew of cocaine use in sinonasal surgery, 73.2 per cent of patients stated they would like a pre-operative discussion on cocaine use before surgery and 83.1 per cent of patients raised concerns over cocaine's illicit status, mainly its effect on work and driving. Only 34 per cent of patients said that they would prefer an alternative to cocaine.

Conclusion

This study found that patients want to know if and when cocaine is being used intra-operatively without necessarily objecting to it.

Keywords

informed consentanesthesia
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 10 , October 2024 , pp. 1036 - 1038
Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Justin Yeo takes responsibility for the integrity of the content of the paper

References

Wang, SH, Wang, HW, Wang, JY. Effects of cocaine on human nasal mucosa. Eur Arch Otorhinolaryngol 1993;250:245–8CrossRefGoogle ScholarPubMed
Campbell, BG. Cocaine abuse with hyperthermia, seizures and fatal complications. Med J Aust 1988;149:387–9CrossRefGoogle ScholarPubMed
Karch, SB. Cocaine: history, use, abuse. J R Soc Med 1999;92:393–7CrossRefGoogle ScholarPubMed
Bard, ND, Antunes, B, Roos, CM, Olschowsky, A, de Pinho, LB. Stigma and prejudice: the experience of crack users. Rev Lat Am Enfermagem 2016;24:e2680CrossRefGoogle ScholarPubMed
Alhaddad, ST, Khanna, AK, Mascha, EJ, Abdelmalak, BB. Phenylephrine as an alternative to cocaine for nasal vasoconstriction before nasal surgery: a randomised trial. Indian J Anaesth 2013;57:163–9Google Scholar
Kasemsuwan, L, Griffiths, MV. Lignocaine with adrenaline: is it as effective as cocaine in rhinological practice? Clin Otolaryngol Allied Sci 1996;21:127–9CrossRefGoogle ScholarPubMed
Long, H, Greller, H, Mercurio-Zappala, M, Nelson, LS, Hoffman, RS. Medicinal use of cocaine: a shifting paradigm over 25 years. Laryngoscope 2004;114:1625–9CrossRefGoogle ScholarPubMed
General Medical Council. Decision making and consent. In: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consent [31 July 2023]Google Scholar
Murdoch, I, Surda, P, Nguyen-Lu, N. Anaesthesia for rhinological surgery. BJA Educ 2021;21:225–31CrossRefGoogle ScholarPubMed
Benjamin, E, Wong, DKK, Choa, D. Moffett's' solution: a review of the evidence and scientific basis for the topical preparation of the nose. Clin Otolaryngol Allied Sci 2005;29:582–7CrossRefGoogle Scholar
Page, DE, Rimmer, J, Keane, M, Manikappa, S, Butzbach, D, Giddings, C. Is atomised intranasal cocaine systemically absorbed during endoscopic sinus surgery? Rhinology 2019;57:200–5Google ScholarPubMed
Department of Transport. Drink and drug driving law. In: https://www.gov.uk/government/collections/drug-driving [31 August 2023]Google Scholar
Lakin, K, Kane, S. Peoples’ expectations of healthcare: a conceptual review and proposed analytical framework. Soc Sci Med 2022;292:114636CrossRefGoogle ScholarPubMed
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