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VOLUME 14 , ISSUE 3 ( September-December, 2022 ) > List of Articles

Original Article

Local Application of 3% Hydrogen Peroxide as Hemostatic Agent in Tonsillectomy

Hemendra Bamaniya, Harbinder S Bhuie, Rajiv K Saxena, Bandana Talukdar

Keywords : Coblation, Cold dissection, Primary hemorrhage, Tonsillectomy

Citation Information : Bamaniya H, Bhuie HS, Saxena RK, Talukdar B. Local Application of 3% Hydrogen Peroxide as Hemostatic Agent in Tonsillectomy. Int J Otorhinolaryngol Clin 2022; 14 (3):92-94.

DOI: 10.5005/jp-journals-10003-1407

License: CC BY-NC 4.0

Published Online: 20-03-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aims and objective: The aim of this study was to assess the hemostatic efficacy of topical application of 3% hydrogen peroxide in tonsillectomy. Materials and methods: The study was conducted in the Department of Otorhinolaryngology, Ananta Institute of Medical Sciences, Rajsamand, Rajasthan, India, for the period of 2 years from July 2016 to July 2018. Eighty randomly selected patients with the clinical diagnosis of chronic tonsillitis with or without adenoid hypertrophy and who underwent tonsillectomy or adenotonsillectomy were included in the study. In group A (n = 40), a gauze piece soaked with 3% hydrogen peroxide was applied to the tonsillar fossa for 5 minutes just after removal of the tonsil. In another 40 patients (group B), a normal saline-impregnated gauze piece was applied to the fossa for 5 minutes. Results were evaluated in terms of duration of surgery, operative blood loss, and the number of ties used to achieve hemostasis. Results: Age of the patients ranged from 4 to 36 years with a mean age of 14.98 years. The number of female patients (57.5%) was more than male patients (42.5%). The average duration of surgery in group A was 27.63 (±9.24) minutes, while in group B, it was 39.3 (±4.13) minutes. The average amount of blood loss in group A was 70.2 (±7.15) mL, while in group B, it was 92.4 (±5.60) mL. The average number of sutures applied in group A was 1, while in group B, it was 2.1. Conclusion: The use of 3% hydrogen peroxide in the tonsillar fossa after removal of the tonsil reduces the duration of surgery, the amount of intraoperative blood loss, and the number of ties used to control bleeding.


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  1. Curtin JM. The history of tonsil and adenoid surgery. Otolaryngol Clin North Am 1987;20(2):415–419. PMID: 3299218.
  2. Worthington TC. A simple method of excision of the faucial tonsil. Journal of the American Medical Association 1907;48: 1761–1762. DOI: 10.1001/jama.1907.25220470029003.
  3. Waugh GE. A simple operation for the removal of tonsils with notes on 900 cases. Lancet 1909a;173(4471):1314–1315. DOI: 10.1016/S0140-6736(00)44599-X.
  4. Waugh GE. An operation for the total excision of tonsils [Letter]. Lancet 1909b;174(4486):572. DOI: 10.1016/S0140-6736(00)69409-6.
  5. Chang HJ, Beek SH, Choi CY, et al. Haemostatic efficacy of topical application of cold hydrogen peroxide in adenoidectomy. Korean J Otolaryngol Head Neck Surg 2003;46:946–949. Retrieved from: http://www.kjorl.org/journal/view.php?number=2535.
  6. Ahmed MA, Abbasi L, Saeed ZK. Hydrogen peroxide 3%: is it beneficial in tonsillectomy? Sultan Qaboob Univ Med J 2006;8(2):201–204. PMID: 21748059.
  7. Fenton JE, Blayney AW, Dwyer TP. Bismuth subgallate–its role in tonsillectomy. J Laryngol Otol 1995;109(3):203–205. DOI: 10.1017/s002221510012969x.
  8. Urban MV, Rath T, Radtke C. Hydrogen peroxide (H2O2): a review of its use in surgery. Wien Med Wochenschr 2017;169(9-10):222–225. DOI: 10.1007/s10345-017-0610-2.
  9. Branemark PI, Ekholm R. Tissue injury caused by wound disinfection. J Bone Joint Surg 1967;49(1):48–62. PMID: 6015758.
  10. Lineweaver W, Howard R, Soucy D, et al. Topical antimicrobial toxicity. Arch Surg 1985;120(3):267–270. DOI: 10.1001/archsurg. 1985.01390270007001.
  11. Shalom AS. Blood loss in ear, nose and throat operations. J Laryngol Otol 1964. DOI: 10.1017/S0022215100062691.
  12. Mesiwala A, Farrell L, Santiago P, et al. The effects of hydrogen peroxide on brain tumors. Surg Neurol 2003;59(5):398–407. DOI: 10.1016/s0090-3019(03)00029-6.
  13. Mut M, Yemisci M, Gursoy-Ozdemir Y, et al. Hydrogen peroxide induced stroke: elucidation of the mechanism in vivo. J Neurosurg 2009;110(1):94–100. DOI: 10.3171/2008.3.17434.
  14. Mushtaq Nemaa, Moayad Nazi Majeed, Ali Abid Saadoon Al-Guzi. Comparison between hydrogen peroxide, iced packs and non-agent packs in tonsillectomy hemostasis. Thi-Qar Med J (TQMJ) 2011;5(3):08–15. Retrieved from: http://www.iasj.net/iasj/download/648045eed115ae25.
  15. Kalloo AN, Canto MI, Wadwa KS, et al. Clinical usefulness of 3% hydrogenperoxide in acute upper GI bleeding: a pilot study. Gastrointest Endosc 1999;49(4 Pt 1):518–521. DOI: 10.1016/s0016-5107(99)70055-6.
  16. Dubey PK, Singh AK. Venous oxygen embolism due to hydrogen peroxide irrigation during posterior fossa surgery. J Neurosurg Anesthesiol 2000;12(1):54–56. DOI: 10.1097/00008506-200001000-00011.
  17. Adoga AA, Okeke ED. Hemostasis during cold dissection tonsillectomy: comparing the use of adrenaline and normal saline. J Clin Med Res 2011;3(7):105–108. DOI: 10.5897/JCMR11.059.
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