Comparison Benefit between Hydrogen Peroxide and Adrenaline in Tonsillectomy: A Randomized Controlled Study

Abstract

This study aimed to further evaluate the benefit of topical hemostasis agents in tonsillectomy. Towards this goal, we compared the clinical effects of topical application between hydrogen peroxide and adrenaline in tonsillectomy. Overall, 60 patients (120 tonsils) were prospectively enrolled for tonsillectomy between February 2018 and December 2020. The patients were randomly assigned to either the hydrogen peroxide or adrenaline group. Then, tonsillectomy was performed using hydrogen peroxide as a hemostatic agent on the assigned side, while adrenaline was applied to the other side. All procedures were performed by a surgeon blinded to the randomization. Outcome measurements of operation time, intraoperative blood loss, postoperative pain, and hemorrhage events were analyzed.The intraoperative blood loss was significantly lower in the hydrogen peroxide group than in the adrenaline group (9.99 ± 4.51 ml vs 13.87 ± 6.32 ml, p = 0.0). The median operation time was also significantly lower in the hydrogen peroxide group (8.02 ± 3.59 min vs 9.22 ± 3.88 min, p = 0.019). Meanwhile, the visual analogue scale (VAS) scores were significantly higher in the hydrogen peroxide group (4.98 ± 1.94 vs 4.27 ± 1.97, p = 0.001). The topical application of hydrogen peroxide as a hemostatic agent effectively decreases the operation time and intraoperative blood loss. Thus, hydrogen peroxide can be used as a routine hemostatic agent for bleeding control in tonsillectomy.

Effect of Topical Hydrogen Peroxide on Postoperative Blood Loss in Patients Undergoing Laminectomy

“…Incidence of postoperative blood loss and transfusion were significantly lower in group H when compared to the control group (47% versus 62%) and (36.5% versus 50%) as shown in table (3).…”

“…H2O2 can be used as a chemical hemostasis agent that is easily degraded by tissue catalase to form oxygen and water. It is a widely available topical antiseptic and nontoxic hemostasis agent that produces oxidative burst and local oxygen production (3) .…”

Is it time to reconsider the use of hydrogen peroxide in hip and knee arthroplasty?

“…Furthermore, hydrogen peroxide has been shown to act as a topical haemostatic agent, thereby temporarily maintaining a bloodless cancellous bed to optimize cement penetration. [2][3][4] Biomechanical studies have investigated the advantage hydrogen peroxide provides in canal preparation. Ackland et al 5 demonstrated a higher tensile load-to-failure when hydrogen peroxide is combined with pulse lavage to treat the intramedullary canal prior to cementing.…”