PAEDIATRIC-02 ROLE OF INTRAOPERATIVE INTRATUMORAL HYDROGEN PEROXIDE IN RESECTION OF SOLID BRAIN TUMORS: CASE SERIES AND BRIEF REVIEW OF LITERATURE

Abstract

Abstract INTRODUCTION The use of Hydrogen peroxide (H2O2) has been reported in surgical literature as one of the best agents for irrigation during neurosurgical procedures for many years due to its purported effects on mechanical debridement and its antiseptic and haemostatic properties although its use has been similarly surrounded by persistent controversy. METHODS We report the intraoperative use of hydrogen peroxide injection in tumour resection among four paediatric patients with different solid brain tumours which included tuberculoma, diffuse B cell lymphoma, pilocytic astrocytoma and medulloblastoma. Following open craniotomy, 3mls of diluted 6% hydrogen peroxide were injected into the exposed solid tumour. The tumour became firmer and evidently more devascularized and this was followed with meticulous bipolar cauterization-resection of the tumour with the aim to achieve total resection. RESULTS Total tumour resection was achieved and the patients recovered uneventfully without any complications. None of the patients in our series developed gas embolism, dysrhythmias nor pneumocephalus. DISCUSSION Hydrogen peroxide irrigation is commonly utilised in neurosurgical procedures for its bactericidal and haemostatic effects. Although several authors have reported adverse complications in literature, we report the judicious safe use of H202 in tumour resection without adverse effects. CONCLUSION The authors report the safe use of intratumoral hydrogen peroxide in resection of solid tumours with aiding control of blood loss and improving resectability. Close observation by the anaesthesiology team is paramount for early detection of gas embolism to avoid adverse outcomes