[Anesthetic care of a patient intoxicated with thinner]

This is a report of a 28 year old male who underwent emergency laparotomy. He had a history of asthma and chronic abuse of thinner (toluene), and he stabbed himself after acute intoxication by the drug. Anesthesia was induced and maintained by halothane and oxygen. Vecuronium was used for muscle relaxation. Abnormal EKG was seen during perioperative period: A-V dissociation and incomplete RBBB. After emergence from anesthesia, so called "flash back" phenomenon was observed but this was controlled by diazepam. Since the chronic abuse of toluene causes organic changes in many vital organs, we must take special precautions when we anesthetize a patient with thinner intoxication: (1) toluene has a negative inotropic effect and also delays the S-A and A-V conduction rate, which may potentiate the cardiac effect of inhalation anesthetics; (2) toluene causes liver damages; and (3) the patient may experience "flash back" phenomenon.