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Anesthesiology/Using "pure" cocaine as a topical anesthetic?

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Question
Hello:

I'm curious as to whether molecularly-pure-cocaine [i.e. cocaine without HCl or other impurities] can be used on the skin to numb that area of the skin?

I guess this molecularly-pure-cocaine could be used to alleviate the symptoms of nasal allergies by applying into the nostril. In addition, this form of cocaine could also be used to eliminate the itch of athlete's foot. Right?


Thank You,

Green

Answer
Hi Green,

Thank you for the question.  I will do my best to answer as appropriately as possible.

Regarding your first question:  Topical cocaine use in the operating room/procedure room, is really surgeon-specific, especially to the concentration/use of (and how often, if at all) for creating an anesthetized environment, as well as causing vasoconstriction to help minimize bleeding during the procedure.  

I have not been around the world practicing anesthesia, so I can only answer to my experiences.  The most concentrated I've seen used is 4% cocaine, which has been mostly used in the nose for reasons stated previously.  I can not attest to knowing of, nor answer your question regarding molecularly-pure cocaine.  If I had to make an educated guess, I would surmise that the higher the concentration of cocaine in the local anesthetic, the more numb the area will be, and perhaps increasing the duration as well.

Regarding your second question:  This forum is not a place to seek medical advice regarding treatment(s) for medical issues.  I would ask you to seek counsel from your primary care provider.

Thanks again for the questions!

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Dino Kattato MSNA CRNA

Expertise

Former ICU/ER RN with several years of experience. I can answer questions relating to the CRNA education process, professional issues involved, as well as questions about adult and pediatric clinical anesthesia.

Experience

Level I regional Trauma center dealing with simple to complex patient populations of all ages. Experience with general anesthesia, spinal and epidural anesthesia, and total IV anesthesia for all surgical specialties including neuro, ortho, general surgery, vascular, electrophysiology, and VIR, with the exception of cardiac anesthesia. Ambulatory surgery center dealing mostly with ENT, plastics, and eyes (70%:30% peds:adults).

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AANA NYSANA

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AANA Journal February 2010 Feb;78(1):24-7. http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Retrieve&list_uids=20977125&dopt=abstractplus

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RN BSN MSNA ACLS/PALS BLS instructor

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