Perioperative Management For the Cocaine-Positive Patient Undergoing Elective Surgery Under General Anesthesia

Cocaine use in the United States is widespread and on the rise.1,2 Due to the increased prevalence of cocaine use, it is likely that the oral and maxillofacial surgeon (OMS) will come across multiple instances of cocaine-positive patients presenting for elective surgery. Studies have already shown that many oral and maxillofacial surgery cases are cancelled due to the presence of cocaine metabolites in urine tests.1,3 Cocaine is a known risk factor for cardiovascular complications (eg, stroke, myocardial infarction, dysrhythmia, angina, hypertension, tachycardia, prolonged QT interval, coronary vasospasm, and aortic dissection)1-4, which in turn influences many providers to cancel elective surgery under general anesthesia.

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