Perioperative medicine & outcomes
Perioperative outcomes in patients with positive cocaine urine tests undergoing elective surgery: A systematic review
Authors' conclusion
Asymptomatic patients with a positive cocaine urine test undergoing elective surgery have not been shown to have higher perioperative complication rates than controls.
Study context
- Population
- Patients scheduled for elective surgery tested for cocaine in urine
- Participants
- 707 patients · 3 cohort studies
- Comparison
- Positive vs negative cocaine urine test
- Outcome
- Perioperative outcomes (haemodynamic events)
Methodological detailsNewcastle-Ottawa Scale quality assessment, PRISMA
- Newcastle-Ottawa Scale quality assessment
- PRISMA
Pooled result
As reported in the abstract
Haemodynamic event incidence
- No significant differences between positive and negative CUT groups
Further pooled results
Vasopressor and antihypertensive use
- Higher vasopressor use with positive CUT (2 studies)
- Increased antihypertensive administration with positive CUT (1 study)
Surgical duration
- Longer with negative CUT (2 studies), without increased haemodynamic instability
Mortality
- No events in the 2 studies assessing mortality
Safety
- No arrhythmias reported
Original publication
Perioperative outcomes in patients with positive cocaine urine tests undergoing elective surgery: A systematic review. J Clin Anesth. Published 25 October 2025. doi:10.
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