Recent cocaine use and the incidence of hemodynamic events during general anesthesia: A retrospective cohort study

J Clin Anesth. 2019 Aug:55:146-150. doi: 10.1016/j.jclinane.2018.12.028. Epub 2019 Jan 16.

Abstract

Study objective: To evaluate the intraoperative hemodynamics and medication requirements of cocaine-positive patients compared to matched cocaine-negative controls.

Design: Retrospective cohort study.

Setting: Public county hospital.

Patients: 821 patients undergoing general anesthesia.

Measurements: Incidence of hemodynamic events, defined by a mean arterial pressure of <65 mmHg or >105 mmHg or a heart rate of <50 beats per minute or >100 beats per minute.

Main results: Cocaine-positive patients did not experience a higher incidence of hemodynamic events when compared with matched cocaine-negative patients. Cocaine-positive patients were not more likely to be administered vasopressors intraoperatively but did receive more anti-hypertensive agents. The minimum alveolar concentration of anesthetics used was similar between the two groups. Anesthesia duration, length of stay, and in-hospital mortality did not significantly differ between the two cohorts.

Conclusions: Cocaine-positive patients did not demonstrate more intraoperative hemodynamic events or adverse short-term outcomes as compared to matched cocaine-negative controls.

Keywords: Anesthesia; Cocaine-related disorders; Hemodynamics; Intraoperative care; Vasopressors.

MeSH terms

  • Adult
  • Anesthesia, General / adverse effects*
  • Antihypertensive Agents / administration & dosage
  • Arterial Pressure / drug effects
  • Arterial Pressure / physiology
  • Case-Control Studies
  • Cocaine / administration & dosage
  • Cocaine / adverse effects*
  • Elective Surgical Procedures / adverse effects*
  • Female
  • Heart Rate / drug effects
  • Heart Rate / physiology
  • Hospital Mortality
  • Humans
  • Hypertension / epidemiology*
  • Hypertension / etiology
  • Hypertension / physiopathology
  • Hypertension / prevention & control
  • Hypotension / epidemiology*
  • Hypotension / etiology
  • Hypotension / physiopathology
  • Hypotension / prevention & control
  • Incidence
  • Intraoperative Care / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Vasoconstrictor Agents / administration & dosage

Substances

  • Antihypertensive Agents
  • Vasoconstrictor Agents
  • Cocaine