Anestesia no paciente usuário de cocaína

Ana Luft; Florentino Fernandes Mendes

doi:10.1590/S0034-70942007000300009

Artigo de Revisão

Anestesia no paciente usuário de cocaína

Anesthesia in cocaine users

Ana Luft; Florentino Fernandes Mendes

http://dx.doi.org/10.1590/S0034-70942007000300009 Braz J Anesthesiol, vol.57, n3, p.307-314, 2007

PDF

Downloads: 5

Resumo

JUSTIFICATIVA E OBJETIVOS: A cocaína é a droga ilícita mais freqüentemente associada a óbitos, e suas implicações perioperatórias nos pacientes agudamente intoxicados ou com história de uso crônico precisam ser bem conhecidas pelos anestesiologistas. O conhecimento da neurofisiologia, da farmacologia e das conseqüências fisiopatológicas decorrentes do uso da cocaína poderá facilitar o cuidado desses pacientes. O objetivo deste trabalho foi revisar as informações sobre a cocaína e suas interações com a anestesia. CONTEÚDO: O artigo discute a farmacologia da cocaína, as conseqüências fisiopatológicas decorrentes do seu uso e as interações com a anestesia. CONCLUSÕES: A compreensão e o reconhecimento precoce das complicações associadas ao uso de cocaína são essenciais para o manuseio adequado de pacientes usuários desta droga. O anestesiologista deve estar preparado, pois tanto as anestesias regionais quanto a geral apresentam riscos significativos nesses pacientes.

Palavras-chave

COMPLICAÇÕES, DROGAS

Abstract

BACKGROUND AND OBJECTIVES: Cocaine is the illicit drug most frequently associated with death, and the anesthesiologist should be aware of the perioperative complications of this drug in patients with acute intoxication or with a history of chronic use. The knowledge of the neurophysiology, pharmacology, and physiopathological consequences of cocaine abuse may facilitate the care of these patients. The objective of this work was to review the information on cocaine and its interactions with anesthesia. CONTENTS: This paper discusses the pharmacology, physiopathological consequences of cocaine use, and its interactions with anesthesia. CONCLUSIONS: The knowledge and early recognition of the complications associated with the use of cocaine are essential for the adequate management of cocaine users. The anesthesiologist should be prepared because both regional and general anesthesia carry significant risks in those patients.

Keywords

COMPLICATIONS, DRUGS

Referências

Lange RA, Hillis LD. Cardiovascular complications of cocaine use. N Engl J Med. 2001;345:351-358.

Gay GR, Inaba DS, Sheppard CW. Cocaine: history, epidemiology, human pharmacology, and treatment. Clin Toxicol. 1975;8.

Calatayud J, Gonzalez . A History of the development and evolution of local anesthesia since the coca leaf. Anesthesiology. 2003;98:1503-1508.

Conversando sobre cocaína e crack. .

Galduróz JCF. Uso e abuso de drogas psicotrópicas no Brasil. Rev IMESC. 2001;3:37-42.

Carlini EA, Nappo AS, Galduróz JCF. A cocaína no Brasil ao longo dos últimos anos. Rev ABP-APAL. 1993;15:121-127.

Noto AR, Carlini EA. Internações hospitalares provocadas por drogas: análise de sete anos consecutivos (1987-1993). Rev ABP-APAL. 1995;17:107-114.

Shanti CM, Lucas CE. Cocaine and the critical care challenge. Crit Care Med. 2003;31:1851-1859.

Karan LD, Benowitz NL. Substance Abuse: Dependence and Treatment. Melmon and Morrelli's Clinical Pharmacology. 2000:1053-1086.

Schindler CW, Tella SR, Erzouki HK. Pharmacological mechanisms in cocaine's cardiovascular effects. Drug Alcohol Depend. 1995;37:183-191.

Bloomstone JA. The drug-abusing parturient. Int Anesthesiol Clin. 2002;40:137-150.

Steadman JL, Birnbach DJ. Patients on party drugs undergoing anesthesia. Curr Opin Anaesthesiol. 2003;16:147-152.

Boghdadi MS, Henning RJ. Cocaine: pathophysiology and clinical toxicology. Heart Lung. 1997;26:466-483.

Hollister LE. Drugs of Abuse. Basic and Clinical Pharmacology. 1992:437-449.

O'Brien CPO. Drug Addiction and Abuse. Goodman's and Gilman's: the Pharmacologic Basis of Therapeutics. 2000:621-642.

Tuncel M, Wang Z, Arbique D. Mechanism of the blood pressure-raising effect of cocaine in humans. Circulation. 2002;105:1054-1059.

Vasica G, Tennant CC. Cocaine use and cardiovascular complications. MJA. 2002;177:260-262.

Whittington R, Virag L, Vulliemoz Y. Anesthesiology. 2002;97:693-700.

Derlet RW, Albertson TE. Potentiation of cocaine toxicity with calcium channel blockers. Am J Emerg Med. 1989;7:464-468.

Hollander JE. The management of cocaine-associated myocardial ischemia. N Engl J Med. 1995;333:1267-1271.

McGoldrick KE. Cardiovascular complications of cocaine use. Surv Anesthesiol. 2002;46:239-240.

Chambers HF, Morris DL, Tauber MG. Cocaine use and the risk for endocarditis in intravenous drug users. Ann Intern Med. 1987;106:833-6.

Burday MJ, Martin SE. Cocaine-associated thrombocytopenia. Am J Med. 1991;91:656-660.

Kuczkowski KM. The cocaine abusing parturient: a review of anesthetic considerations. Can J Anaesth. 2004;51:145-154.

Orser B. Thrombocytopenia and cocaine abuse. . 1991;74:195-196.

Gershon RY, Fisher AJ, Graves WL. The cocaine-abusing parturient is not at an increased risk for thrombocytopenia. . 1996;82:865-866.

Dhuna A, Pascual-Leone A, Langendorf F. Epileptogenic properties of cocaine in humans. Neurotoxicology. 1991;12:621626.

Fahim I, Ismail M, Osman OH. Hypothermic effect of cocaine in rats. West Afr J Pharmacol Drug Res. 1975;2:48-56.

Long SF, Davis WM, Waters IW. Additive hypothermic effects of cocaine and nicardipine in guinea-pigs. Gen Pharmacol. 1994;25:1585-1590.

Qureshi AI, Akbar MS, Czander E. Crack cocaine use and stroke in young patients. Neurology. 1997;48:341-345.

Merkel PA, Koroshetz WJ, Irizarry MC. Cocaine-associated cerebral vasculitis. Semin Arthritis Rheum. 1995;25:172-183.

Aggrawal SK, Williams V, Levine SR. Cocaine-associated intracranial hemorrhage: absence of vasculitis in 14 cases. Neurology. 1996;46:1741-1743.

Nolte KB, Brass LM, Fletterick CF. Intracranial hemorrhage associated with cocaine abuse: a prospective autopsy study. Neurology. 1996;46:1291-1296.

Cruz R, Davis M, O'Neil H. Pulmonary manifestations of inhaled street drugs. Heart Lung. 1998;27:297-305.

Albertson TE, Walby WF, Derlet RW. Stimulant-induced pulmonary toxicity. Chest. 1995;108:1140-1149.

Haim DY, Lippmann ML, Goldberg SK. The pulmonary complications of crack cocaine: a comprehensive review. Chest. 1996;107:233-240.

Tashkin DP, Kleerup EC, Koyal SN. Acute effects of inhaled and i.v. cocaine on airway dynamics. Chest. 1996;110:904-910.

Baldwin GC, Tashkin DP, Buckley DM. Marijuana and cocaine impair alveolar macrophage function and cytocine production. Am J Respir Crit Care Med. 1997;156:1606-1613.

Baldwin GC, Buckley DM, Roth MD. Acute activation of circulating polymorphonuclear neutrophilis following in vivo administration cocaine. A potential etiology for pulmonary injury. Chest. 1997;111:698-705.

Herrine SK, Park PK, Wechsler RJ. Acute mesenteric ischemia following intranasal cocaine use. Dig Dis Sci. 1998;43:586-589.

Vertommen JD, Hughes SC, Rosen MA. Hydralazine does not restore uterine blood flow during cocaine-induced hypertension in the pregnant ewe. Anesthesiology. 1992;76:580-587.

Kuczkowski KM. Caesarean section in a cocaine-intoxicated parturient: regional vs. general anaesthesia?. Anaesthesia. ;58:1042-1043.

Fleming JA, Byck R, Barash PG. Pharmacology and therapeutic applications of cocaine. Anesthesiology. 1990;73:518-531.

Anestesia no paciente usuário de cocaína

Anesthesia in cocaine users

Ana Luft; Florentino Fernandes Mendes

Resumo

Palavras-chave

Abstract

Keywords

Referências

Links

Compartilhar

Braz J Anesthesiol