Cocaine Use and Outcomes of General Anesthesia
Cocaine Use and Outcomes of General Anesthesia
In this prospective study, investigators plan to evaluate the outcome of general anesthesia
 in the context of patients with a positive cocaine urine test. Patients with a positive urine
 cocaine test who do not appear acutely toxic and have normal vital signs may not have an
 increased rate of perioperative complications during elective surgery compared to similar
 patients with negative urine cocaine screening tests. Patients who are chronic cocaine users
 may have a higher anesthetic requirement.
Patients with a history of cocaine abuse who are scheduled to undergo surgery at Parkland
 Hospital will be asked to provide a urine sample for a screening toxicology test on the day
 of surgery. Patients will also be asked to fill out a questionnaire with questions pertaining
 to their drug use history. The remaining aspects of perioperative care, including the general
 anesthetic technique, will be standardized for all patients and will not differ from the
 standard of care. The anesthesia faculty, resident, or CRNA will identify patients and obtain
 consent and ask the patient to fill out the questionnaire. This prospective study is intended
 to enroll about 300 cocaine positive and negative patients over a 2 year period.

 Blood samples will be collected for analysis of cardiac troponin T (cTnT) pre- and
 postoperatively.
Inclusion Criteria:

 -  18-70 years old

 -  ASA physical status classification 1 to 3

 -  Personal history of cocaine abuse

 -  Scheduled for a non-emergent operation that requires general anesthesia

 -  Vital signs within generally accepted ranges for normal [HR 60-100, RR 12-20, SpO2 >
 96% on room air, BP 90-140/60-90 unless a diagnosis of hypertension is present, T
 36-38 degrees)

 -  Willing and able to consent in English or Spanish

 Exclusion Criteria:

 -  Age less than 18 or older than 70

 -  Unable to give informed consent for participation in the study

 -  Patient refusal

 -  Monitored anesthesia care (MAC) or regional anesthesia planned

 -  Pregnant or lactating

 -  Emergent surgery

 -  Acute cocaine intoxication based on clinical symptomatology (hypertension,
 tachycardia, agitation, delirium, hyperthermia)

 -  History of cardiac disease including coronary artery disease (CAD) and cardiac
 dysrhythmia

 -  History of stroke

 -  History of seizure disorder

 -  ESRD

 -  Prison patient