Cocaine toxicity during dacryocystorhinostomy

Arch Ophthalmol. 1980 May;98(5):842-3. doi: 10.1001/archopht.1980.01020030836006.


Toxic effects were observed in two healthy patients who received cocaine intranasally before dacryocystorhinostomy. One patient suffered an additional reaction to intranasally administered phenylephrine (Neo-Synephrine) hydrochloride. Because cocaine blocks uptake of catecholamines and has a sympathetic potentiating effect, its use is dangerous in patients with hypertensive cardiovascular disease or in conjunction with sympathomimetic or alpha-modifying drugs. Use of dilute solutions carefully measured for select patients is mandatory. The total dose of cocaine should not exceed 3 mg/kg.

Publication types

  • Case Reports

MeSH terms

  • Administration, Topical
  • Adult
  • Child
  • Cocaine / administration & dosage
  • Cocaine / adverse effects*
  • Female
  • Humans
  • Hypertension / chemically induced*
  • Lacrimal Apparatus / surgery*
  • Male
  • Nasal Cavity / surgery*
  • Phenylephrine / adverse effects
  • Tachycardia / chemically induced


  • Phenylephrine
  • Cocaine