Name of the Procedure:

Cocaine (Topical Cocaine, Cocaine Hydrochloride)

Summary

Topical cocaine is a procedure where a cocaine-based solution is applied to specific areas, typically inside the nose, to provide localized anesthesia and reduce bleeding during certain medical examinations or minor surgeries.

Purpose

Topical cocaine is primarily used to create numbness and reduce bleeding in nasal passages and occasionally in throat procedures. This helps in performing endoscopies or minor surgical interventions with minimal discomfort and improved visibility for the practitioner.

Indications

• Nasal and sinus diagnostic procedures
• Minor nasal surgeries, such as septoplasty
• Procedures involving the nasal cavity where bleeding control is necessary
• Cases requiring rapid and localized anesthesia of nasal tissues

Preparation

• Patients should disclose any medical history of cardiovascular issues, substance abuse, allergies, or current medications.
• Fasting is generally not required.
• Pre-procedure assessments may include an evaluation of cardiovascular health.

Procedure Description

1. The patient is comfortably seated or reclined.
2. A cotton swab soaked in a cocaine solution (typically 4-10%) is applied inside the nasal cavity.
3. The solution is left in place for a few minutes to ensure adequate absorption and effect.
4. The healthcare provider proceeds with the diagnostic or minor surgical procedure while the cocaine solution numbs the area and constricts blood vessels to reduce bleeding.
5. After the procedure, the swab is removed, and any excess solution is cleaned.

Duration

The application of cocaine and the procedure combined typically take 30 to 60 minutes, depending on the complexity and scope of the intervention.

Setting

This procedure is usually performed in an outpatient clinic, a hospital's ENT department, or a surgical center.

Personnel

• ENT specialists (otolaryngologists)
• Nurses
• Potentially an anesthesiologist for more extensive surgeries

Risks and Complications

• Cardiovascular issues (e.g., increased heart rate, high blood pressure)
• Local irritation or tissue damage
• Allergic reactions
• Risk of systemic effects if absorbed into the bloodstream in higher quantities
• Rare risk of overdose if significant quantities are used or absorbed

Benefits

• Immediate and effective local anesthesia
• Significant reduction in bleeding, improving the clarity of the surgical field
• Minimal patient discomfort during the procedure

Recovery

• Patients can usually return to normal activities shortly after the procedure.
• Some minor nasal discomfort or congestion may be experienced.
• Follow-up appointments may be scheduled to monitor the surgical site or efficacy of any diagnostic findings.

Alternatives

• Lidocaine or other local anesthetics, though they may not be as effective in controlling nasal bleeding
• General anesthesia for extensive or highly sensitive procedures, with more extensive preparation and recovery time

Patient Experience

• During the application, patients may feel a slight burning or tingling sensation.
• Minimal pain is expected during the procedure due to the numbing effects of cocaine.
• Post-procedure, patients may notice slight nasal congestion or mild discomfort, which typically resolves quickly.