Ventricular fibrillation following local application of cocaine and epinephrine for nasal surgery.

We report the case of a 17-year-old female patient, scheduled for septoplasty under general anesthesia, who developed ventricular fibrillation after intranasal application of cocaine (350 mg) and submucosal injection of lidocaine (20 mg) with epinephrine (100 micrograms). Resuscitation by external chest compression was successful, and normal sinus rhythm was reestablished after lidocaine injection (50 mg, i.v.). The cardiac risk of the combined administration of cocaine and epinephrine during general anesthesia are discussed.