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Indications: FDA : Topical anesthesia of the upper respiratory tract (due to its combined vasoconstrictor & local anesthetic properties) Off Label : Use in Emergency Department as one ingredient in a topical anesthetic solution called TAC (containing: Tetracaine, Adrenaline & Cocaine) that is applied to a wound prior to cleaning & suturing Contraindications: Hypersensitivity to ester anesthetics Side Effects: Acute signs of systemic toxicity include can include multiple signs of both CV & CNS stimulation: tachycardia hypertension hyperthermia mydriasis seizures cardiac arrhythmias (multiple contributing variables: Na & K channel block, possible coronary vasoconstriction) Acute effects associated with cocaine abuse

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Case example : A patient receives laparoscopic gastric sleeve resection (sleeve gastrectomy)