Accurate measurement of dose and patience are important

doi:10.1136/bmj.311.7012.1089a

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Peter Williamson,
Robert Slack

Registrar in ear, nose, and throat Consultant ear, nose, and throat surgeon Royal United Hospital, Bath BA1 3NG

EDITOR,--K E A Nicholson and J E G Rogers's lesson of the week about arrhythmias associated with the use of cocaine and adrenaline paste1 is bound to fuel the controversy surrounding the use of these two drugs in sinonasal surgery. It is unclear from their report whether the overdose of cocaine was intentional or inadvertent: all three patients reported on received two to three times the maximum recommended dose of cocaine for their weight. With no evidence of similar complications when cocaine is used …