Recent cocaine use and the incidence of hemodynamic events during general anesthesia: A retrospective cohort study

Study objective: To evaluate the intraoperative hemodynamics and medication requirements of cocaine-positive patients compared to matched cocaine-negative controls. Design: Retrospective cohort study. Setting: Public county hospital. Patients: 821 patients undergoing general anesthesia. Measurements: Incidence of hemodynamic events, defined by a mean arterial pressure of < 65 mmHg or > 105 mmHg or a heart rate of < 50 beats per minute or > 100 beats per minute. Main results: Cocaine-positive patients did not experience a higher incidence of hemodynamic events when compared with matched cocaine-negative patients. Cocaine-positive patients were not more likely to be administered vasopressors intraoperatively but did receive more anti-hypertensive agents. The minimum alveolar concentration of anesthetics used was similar between the two groups. Anesthesia duration, length of stay, and in-hospital mortality did not significantly differ between the two cohorts. Conclusions: Cocaine-positive patients did not demonstrate more intraoperative hemodynamic events or adverse short-term outcomes as compared to matched cocaine-negative controls.