A comparison between the efficacy of methylphenidate and cocaine for nasal vasoconstriction before nasal surgery—A randomized prospective study

Ramaiyan Velmurugan, J. Dhanush

Article ID: 2114
Vol 4, Issue 2, 2023
DOI: https://doi.org/10.54517/ccr.v4i2.2114
Received: 5 October 2023; Accepted: 18 November 2023; Available online: 5 December 2023;
Issue release: 31 December 2023

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Abstract

Objectives: Cocaine is regularly utilized topically to give the vasoconstriction to nasal medical procedure; However, it is said to create intraoperative cardiovascular unfriendly impacts. Methylphenidate was considered in the place of cocaine as a substitute to look at the vasoconstriction in nasal medical procedure. Methods: Outcome of the study will be examining the vasoconstriction based on a 5-point scale (1 = unacceptable, 5 = excellent), followed by the administration of either 20–30 mg per day methylphenidate or 4% cocaine randomly to the adult patients subjected to nasal septoplasty. Results: Methylphenidate and cocaine were administered with 38 and 28 patients respectively. The quality of vasoconstriction was noticed to be good in both the groups with the median rating of 4.0 and a P value of 0.85. With both the gatherings, the median blood loss was 46 and 58 ml with a p estimation of 0.48. A non-mediocrity delta of 1 point with a p estimation of 0.009 and non-inadequacy delta of 24 ml with a p esteem 0.026 concerning vasoconstriction and blood loss individually is seen which demonstrates methylphenidate is comparable to cocaine. Non importance is noted with the recurrence of ventricular ectopy, ST section changes after nasal packing with the gatherings. Conclusions: With the results obtained, methylphenidate can be very well replaced for cocaine for vasoconstriction in septoplasty. As there are lot many underlying chances for cocaine abuse and administrative issues related to its handling, methylphenidate may serve as a substitute.


Keywords

cocaine; vasoconstriction; local anaesthetics; nasal medical procedure; methylphenidate


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