SERIOUS CARDIAC-ARRHYTHMIA FOLLOWING PREOPERATORY INJECTION OF PHENOLFOR SPLANCHNIC NEUROLYSIS

The cardiac toxicity of phenol is known. A variety of cardiac arrhythm ias has been noted, particularly after application to the skin, more r arely when used for neurolysis. We report a case of severe cardiac arr hythmia followed by circulatory arrest in a patient with pancreatic ca ncer which occurred a few minutes after injecting 30 ml phenol 6.66% t o produce splanchnic neurolysis. Due to the cardiotoxicity of phenol, recommendations are made for the prevention of cardiac arrhythmias. Wh en high doses of phenol are used on the skin, e.g., face peeling, appl ications should be over small areas with division of the phenol to eac h area a sufficient iv fluid load should be given, forcing diuresis wi th furosemide may be given, and lidocaine hydrochloride used as a prop hylactic antiarrythmic agent. In these cases, as for neurolysis (low d oses of phenol), ECG monitoring is mandatory. For neurolysis, alcohol could with advantage replace phenol.