Alshardan Mohammad M, Abunimer Abdullah M, Abou-Al-Shaar Hussam, Aldandan Sadeq, El-Watidy Sherif M, Mustafa Ali M, Sabbagh Abdulrahman J
Department of Surgery, Division of Neurosurgery, The Ottawa Hospital, University of Ottawa, Civic Campus, Ottawa, ON, Canada.
Department of Neurosurgery, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts.
Surg Neurol Int. 2021 Mar 8;12:91. doi: 10.25259/SNI_26_2020. eCollection 2021.
Hydrogen peroxide (HP) is routinely used in neurosurgical procedures to achieve surgical hemostasis. However, its safety profile is still debatable with various reports depicting range of adverse effects on neuronal tissue. The objective of this paper is to evaluate the safety and efficacy of HP as a hemostatic agent in normal neuronal tissue during neurosurgical procedures conducted on rats.
One hundred rats were divided into three groups. The first and third group underwent cortical irrigation with HP and the second group underwent spinal irrigation with HP. All groups were irrigated with different concentrations of HP (1%, 3%, or 6%) for 3 min and tissue biopsies were obtained immediately afterwards (Groups A and B) or 1 week after HP irrigation (Group C). Study specimens were examined histologically and compared to control tissue.
All rats showed normal behavioral, functional, and motor neurological activity following the procedures. Histopathologically, dark neurons were observed in all HP exposed tissue. The cytoplasm revealed condensed and dark Nissl substance and the neurites and axons exhibited a corkscrew morphology. No ischemic changes or inflammatory infiltrates were detected. The majority of dark neurons were observed at the periphery of tissue fragments. These findings were present and consistent in both the short- and long-term groups.
HP irrigation showed no significant short- or long-term clinical and histopathological changes in comparison to normal saline when used on rats' neuronal tissue. This may confirm the safety of intraoperative HP usage as hemostatic agent during neurosurgical procedures.
过氧化氢（HP）常用于神经外科手术以实现手术止血。然而，其安全性仍存在争议，各种报告描述了其对神经组织的一系列不良反应。本文的目的是评估在对大鼠进行的神经外科手术中，HP作为正常神经组织止血剂的安全性和有效性。
将100只大鼠分为三组。第一组和第三组用HP进行皮质冲洗，第二组用HP进行脊髓冲洗。所有组均用不同浓度的HP（1%、3%或6%）冲洗3分钟，然后立即（A组和B组）或在HP冲洗后1周（C组）获取组织活检样本。对研究标本进行组织学检查并与对照组织进行比较。
所有大鼠在手术后均表现出正常的行为、功能和运动神经活动。组织病理学上，在所有暴露于HP的组织中均观察到深色神经元。细胞质显示尼氏体浓缩且颜色变深，神经突和轴突呈现螺旋状形态。未检测到缺血性改变或炎性浸润。大多数深色神经元出现在组织碎片的周边。这些发现在短期和长期组中均存在且一致。
与生理盐水相比，在大鼠神经组织上使用HP冲洗未显示出明显的短期或长期临床和组织病理学变化。这可能证实了在神经外科手术中术中使用HP作为止血剂的安全性。
