GasGasGas - Anaesthetic Science for Anaesthesia! Cocaine: Local Anaesthetic Properties & Pharmacology + Hx Spinal Anaesthesia!
Jul 17, 2025
Dive into the wild world of cocaine in medicine! Discover its rich history in spinal anesthesia and its chemistry as a local anesthetic. Learn about the various clinical uses and limitations, as well as the alarming side effects on the cardiovascular and respiratory systems. Delve into the fascinating topic of cocaethylene and how it intensifies toxicity when mixed with alcohol. Plus, get expert guidance on managing cocaine toxicity in the clinical setting. It's a rollercoaster of medical insight and caution!
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Early Spinal Cocaine Experiments
- August Beer tested intrathecal cocaine with his assistant and used needle pricks, testicular traction and shin hammering to confirm anaesthesia.
- Theodore Tufière later popularised the technique and coined Tufière's line for spinal levels.
Cocaine Is An Ester Topical Anaesthetic
- Cocaine hydrochloride is an ester local anaesthetic typically used topically as a 10% solution and is water soluble.
- It has a molecular weight of 311 and belongs to the ester class broken down by esterases.
Multiple Mechanisms Of Action
- Cocaine blocks sodium channels to produce local anaesthesia and causes potent local vasoconstriction.
- It also inhibits reuptake of dopamine, noradrenaline, adrenaline and serotonin producing sympathomimetic and CNS effects.