Venous oxygen embolism due to hydrogen peroxide irrigation during posterior fossa surgery.
Hazards of application of hydrogen peroxide to semiclosed space are well known. We present a case of suspected gas embolism following hydrogen peroxide irrigation of the surgical field during posterior fossa surgery in the prone position. Severe cardiovascular collapse occurred when the wound was irrigated with hydrogen peroxide solution. Generation of pressure gradient leads to absorption of a considerable amount of oxygen giving rise to features of venous gas embolism. Although the case was associated with an uneventful recovery, use of hydrogen peroxide for securing hemostasis should be avoided.
Dubey
P K
PK
Department of Anesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, India.
Singh
A K
AK
D000042:Absorption; D000328:Adult; D001794:Blood Pressure; D002245:Carbon Dioxide / Q000097:blood; D003388:Cranial Fossa, Posterior / Q000601:surgery; D003399:Craniotomy; D004618:Embolism, Air / Q000139:chemically induced*; D006339:Heart Rate; D006490:Hemostatics / Q000009:adverse effects*; D006801:Humans; D006861:Hydrogen Peroxide / Q000009:adverse effects*; D007431:Intraoperative Complications; D008297:Male; D009777:Occipital Bone / Q000601:surgery*; D016877:Oxidants / Q000009:adverse effects*; D010100:Oxygen / Q000097:blood / Q000493:pharmacokinetics; D016684:Prone Position; D012769:Shock / Q000209:etiology; D019292:Skull Base Neoplasms / Q000601:surgery; D007507:Therapeutic Irrigation
D006490:Hemostatics; D016877:Oxidants; D002245:Carbon Dioxide; D006861:Hydrogen Peroxide; D010100:Oxygen