Abstract
Hydrogen peroxide is used to cleanse and irrigate wounds. As it decomposes immediately into water and oxygen on contact with organic tissue, it is usually regarded as a safe agent. We report a case of oxygen embolism associated with hydrogen peroxide irrigation of the surgical field during anterior fusion of the cervical vertebrae. It was accompanied by precipitous hypotension and decrease in pulse oximetry oxygen saturation and end-tidal CO2 tension. Semi-closed spaces formed under the apatite dowel and between the apatite dowel and vertebral bodies may have precipitated the absorption of oxygen bubbles into the vasculature. Although this case was associated with a rapid recovery and uneventful sequelae, it discourages the use of hydrogen peroxide in this procedure because of the potential hazards including cardiovascular collapse.
Résumé
On utilise le peroxyde d’hydrogène pour nettoyer et irriguer les plaies. Comme il se décompose instantanément en eau et en oxygène au contact d’un tissus organique, on le considère inoffensif. Nous rapportons un cas d’embolie associée à l’irrigation d’une plaie au peroxyde d’hydrogène pendant une fusion cervicale antérieure. L’embolie s’est manifestée par une hypotension subite et une chute de la saturation en oxygène et du CO2 téléexpiratoire. La présence d’espaces semi-clos sous le pivot d’apatite et entre le pivot d’apatite et le corps vertébral peut avoir précipité l’absorption des bulles d’oxygène dans l’arbre vasculaire. Bien que ce malade ait récupéré rapidement et sans séquelles, il est préférable de ne pas utiliser le peroxyde d’hydrogène pendant cette intervention à cause du danger inhérent de collapsus vasculaire.
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Morikawa, H., Mima, H., Fujita, H. et al. Oxygen embolism due to hydrogen peroxide irrigation during cervical spinal surgery. Can J Anaesth 42, 231–233 (1995). https://doi.org/10.1007/BF03010684
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DOI: https://doi.org/10.1007/BF03010684