García-Velasco P, García C, Parramon F, Villalonga A, Beltrán de Heredia B
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital de Girona Dr. Josep Trueta.
Rev Esp Anestesiol Reanim. 1997 Mar;44(3):124-6.
Hydrogen peroxide solution (H2O2) is used to irrigate and clean wounds. When applied to tissue hydrogen peroxide decomposes rapidly as a result of the action of catalases, releasing oxygen in the process. High pressure irrigation of the washing of closed cavities can cause serious complications. We report a case of gas embolism arising from the use of hydrogen peroxide during surgery for hydatidosis of the liver. A 64-year-old woman underwent surgery for removal of a hydatid cyst of the liver. When pressurized injection of 10 ml of 3% hydrogen peroxide was applied to the cystic cavity, cardiac arrhythmias were observed, a long with decreased PetCO2, hypotension and a "water mill" heart murmur. Gas embolism was suspected and treatment was instated immediately. Clinical course was good and without complications. We wish to warn against the potential dangers of using peroxide during surgery and of the importance of capnography for early diagnosis of gas embolism.
过氧化氢溶液（H₂O₂）用于冲洗和清洁伤口。当应用于组织时，由于过氧化氢酶的作用，过氧化氢会迅速分解，在此过程中释放出氧气。对封闭腔隙进行高压冲洗可能会导致严重并发症。我们报告一例在肝包虫病手术期间因使用过氧化氢而引发气体栓塞的病例。一名64岁女性接受了肝包虫囊肿切除术。当向囊腔内加压注入10毫升3%的过氧化氢时，观察到心律失常，同时伴有呼气末二氧化碳分压降低、低血压和“水车样”心脏杂音。怀疑发生气体栓塞并立即开始治疗。临床过程良好，未出现并发症。我们希望提醒注意手术期间使用过氧化氢的潜在危险以及二氧化碳监测对于气体栓塞早期诊断的重要性。
