Posted by Dr. Anil R. Shah

Does Dr. Shah use topical Cocaine as an anesthetic in rhinoplasty?

Cocaine is one of the traditional agents used in rhinoplasty and septoplasty to both anesthetize the nose and cause vasocontriction*. The main issue with the use of cocaine is the potential for cardiac arrhythmia*. So do the pros of its use outweigh the cons?

Dr. Shah does not use cocaine as a topical anesthetic in septorhinoplasty. There are several reasons behind this. First, although studies have shown that cocaine is safe in the nose, there is still a small chance of cardiac arrhythmia. In addition, a recent study in the European Archives of Otorhinolaryngology from Queens Hospital found no benefit in the use of cocaine versus epinephrine. Modern inhalational gas anesthetic agents also cause less vasodilation than agents in the past. This makes a topical agent like cocaine unnecessary.

So what does Dr. Shah uses instead of topical cocaine?

Dr. Shah uses liodcaine with epinephrine in combination with Afrin nasal spray for vasoconstriction in rhinoplasty in concert with modern inhalation gas agents. This combination works well for both short and long nasal cases.

*Vasoconstriction – Narrowing of blood vessels. When blood vessels constrict, blood flood is slowed or blocked.

*Arrhythmia – An irregular heartbeat.

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