Abstract
La toxicité cardiaque du phénol est connue. Des troubles du rythme cardiaque variés ont été signalés, surtout après application cutanée de phénol, plus rarement après neurolyse. Nous rapportons un cas de troubles du rythme cardiaque graves, avec arrêt circulatoire, chez un patient atteint d’un cancer du pancréas. L’accident est survenu quelques minutes après l’injection de trente millilitres de phenol à 6,66% dans le but de pratiquer une neurolyse splanchnique. En raison de la toxicité cardiaque du phénol, certaines précautions sont à prendre. En cas d’utilisation de fortes doses de phénol (peeling facial): applications espacées dans le temps, sur de petites surfaces; expansion volémique; diurèse forcée; administration de lidocaïne. Dans ce cas, comme dans celui des neurolyses (faible dose de phénol), la surveillance de l’ECG est indispensable. Pour les neurolyses, l’alcool pourrait remplacer avantageusement le phénol.
Abstract
The cardiac toxicity of phenol is known. A variety of cardiac arrhythmias has been noted, particularly after application to the skin, more rarely when used for neurolysis. We report a case of severe cardiac arrhythmia followed by circulatory arrest in a patient with pancreatic cancer which occurred a few minutes after injecting 30 ml phenol 6.66% to produce splanchnic neurolysis. Due to the cardiotoxicity of phenol, recommendations are made for the prevention of cardiac arrhythmias. When high doses of phenol are used on the skin, e.g., face peeling, applications should be over small areas with division of the phenol to each area a sufficient iv fluid load should be given, forcing diuresis with furosemide may be given, and lidocaine hydrochloride used as a prophylactic antiarrythmic agent. In these cases, as for neurolysis (low doses of phenol), ECG monitoring is mandatory. For neurolysis, alcohol could with advantage replace phenol.
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Gaudy, JH., Tricot, C. & Sezeur, A. Troubles du rythme cardiaque graves après phénolisation splanchnique peropératoire. Can J Anaesth 40, 357–359 (1993). https://doi.org/10.1007/BF03009635
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DOI: https://doi.org/10.1007/BF03009635