Open AccessSafety of upper endoscopy in patients with active cocaine use
Author(s) -
Anabel Liyen Cartelle,
Alexander Nguyen,
Parth Desai,
Vikram Kotwal,
Jinal Makhija,
Jie Yu,
John Erikson Yap
Publication year - 2021
Publication title -
world journal of gastrointestinal endoscopy
Language(s) - English
Resource type - Journals
ISSN - 1948-5190
DOI - 10.4253/wjge.v13.i10.510
Subject(s) - medicine , esophagogastroduodenoscopy , benzoylecgonine , adverse effect , exact test , blood pressure , ureteroscopy , anesthesia , endoscopy , statistical significance , emergency medicine , urine , surgery , ureter
Cocaine is a synthetic alkaloid initially viewed as a useful local anesthetic, but which eventually fell out of favor given its high addiction potential. Its predominantly sympathetic effects raise concern for cardiovascular, respiratory, and central nervous system complications in patients undergoing procedures. Peri-procedural cocaine use, often detected via a positive urine toxicology test, has been mostly addressed in the surgical and obstetrical literature. However, there are no clear guidelines on how to effectively risk stratify patients found to be positive for cocaine in the pre-operative setting, often leading to costly procedure cancellations. Within the field of gastroenterology, there is no current data available regarding safety of performing esophagogastroduodenoscopy (EGD) in patients with recent cocaine use.