a case of cardiac arrest after topical phenylephrine administration in adenoidectomy surgery

Some otolaryngologists administer topical phenylephrine for bleeding control in adenoidectomy surgery. absorption of this drug from surgical site can lead to increase in blood pressure due to vasoconstriction and then bradycardia related to baroreceptore reflex.  our case was an intraoperative arrest of a 9yrsold girl related to administration of topical phenylephrine during adenoidectomy however, bradycardia is a rare complication of topical phenylephrine in ent surgeries probably due to preoperative administration of atropine or glycopirolate. due to severe complications have been ever seen, avoidance of topical administration of phenylephrine or other vasoconstrictors with undetermined doses is reasonable.