Hydrogen Peroxide as a Haemostatic Agent in Tonsillectomy Bleed: An Overview

Area of Science:

• Otolaryngology
• Surgical Hemostasis
• Pharmacology

Background:

• Tonsillectomy is a common ENT procedure, often indicated for chronic tonsillitis.
• Post-tonsillectomy hemorrhage is a significant, potentially life-threatening complication.
• Effective hemostasis techniques are crucial for patient safety.

Purpose of the Study:

• To evaluate the vasoconstrictive and hemostatic properties of 3% hydrogen peroxide in tonsillectomy.
• To compare the efficacy of hydrogen peroxide versus normal saline in controlling bleeding during tonsillectomy.

Main Methods:

• A study involving 133 patients undergoing tonsillectomy for chronic tonsillitis using the Dissection and Snare technique.
• Patients requiring cautery/knot for hemostasis were excluded (n=23).
• Right tonsil dissection served as Group 1 (normal saline soaked cotton), left tonsil as Group 2 (3% hydrogen peroxide soaked cotton).

Main Results:

• Group 2 (hydrogen peroxide) showed a 14.97% reduction in average dissection time (12.15 min vs. 14.29 min).
• Group 2 demonstrated a 16.04% reduction in average blood loss (47.41 ml vs. 56.47 ml).
• No complications were reported in either group.

Conclusions:

• 3% Hydrogen peroxide is a potent antimicrobial and hemostatic agent when applied to the tonsillar fossa post-tonsillectomy.
• Moderate use of hydrogen peroxide is effective in minimizing blood loss during tonsillectomy.
• Hydrogen peroxide presents a safe hemostatic option with no serious associated complications.