Significant numbers of patients are seen for surgery and anesthesia with a history of chronic substance abuse. However, little is known about how these substances influences anesthetic physiology and pharmacology.
Abuse of substances may involve a socially acceptable drug (e.g., alcohol, tobacco), a medically prescribed drug (e.g., diazepam), or an illegal substance (e.g., cocaine). Knowledge of a patient�s substance abuse prior to administration of analgesia or anesthesia may prevent adverse drug interactions, predict tolerance to anesthetic agents, and/or facilitate the recognition of drug withdrawal.
As the neurobehavioral effects of cocaine may increase the likelihood that a user will receive violent fatal injuries and is more prone to have emergency surgery, so we stressed here on this substance. Cocaine abuse is associated with multi-target organ involvement, including the cardiovascular, respiratory, neurologic, and hematological systems. Its use during pregnancy is also an independent contributor to the risk of placental abruption, preterm labor and stillbirth.