Cocaine use in sinonasal surgery: patients' perspective on its use and the need for pre-operative consent

Abstract

Introduction Intranasal cocaine is commonly used in endoscopic sinus surgery due to its vasoconstrictive and anaesthetic properties. We aim to understand patients' perspectives and whether we should consent patients to its use. Method Prospective data was collected over a three-month period in ENT departments in the outpatient setting of 2 district general hospitals. An anonymous questionnaire was distributed to all adult patients exploring their thoughts on cocaine use in sinonasal surgery and the need for perioperative discussion. Results 123 patients questionnaires were analyzed. 9.8% of patients knew of cocaine use in sinonasal surgery. 73.2% of patients stated they would like a pre-operative discussion on cocaine use before surgery. 83.1% of patients raised concerns over cocaine's illicit status, mainly its effect on work and driving. Only 34% mentioned they would prefer an alternative. Conclusion Patients want to know if and when cocaine is being used intraoperatively without necessarily objecting to it.