The Value of Hydrogen Peroxide in Neurosurgery and Its Pathophysiological Effects in Human and Animal Brain Tissues
<b>Background</b>: Hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) is a well-known hemostatic and antiseptic agent in neurosurgical practice. While there are concerns regarding the use of H<sub>2</sub>O<sub>2</sub> due to its potential for n...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-04-01
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| Series: | Pharmaceuticals |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1424-8247/18/4/533 |
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| Summary: | <b>Background</b>: Hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) is a well-known hemostatic and antiseptic agent in neurosurgical practice. While there are concerns regarding the use of H<sub>2</sub>O<sub>2</sub> due to its potential for neuronal damage, the pathophysiological effect on neuronal cells is not clearly understood. <b>Methods</b>: An online survey concerning the use of H<sub>2</sub>O<sub>2</sub> was conducted in a board-certified platform, and an experimental study was designed to investigate the effect of H<sub>2</sub>O<sub>2</sub> on neuronal and tumor cells. Brain tissues of mice and brain/tumor tissues of humans were irrigated with H<sub>2</sub>O<sub>2</sub> 3%, H<sub>2</sub>O<sub>2</sub> 1.5%, and NaCl 0.9%, and processed by bipolar coagulation. Tissue sections were obtained and stained with H&E and analyzed by the depth and degree of neuronal damage measured from the cortical surface (μm). <b>Results</b>: In total, 242 neurosurgeons participated in the survey, and 81% of neurosurgeons reported use of H<sub>2</sub>O<sub>2</sub> in neurosurgical practice. however only 5% of the participants had a literature-based knowledge of the pathophysiological mechanism of H<sub>2</sub>O<sub>2</sub>. In total, eight mouse brain tissues, 21 human brain tissues, and seven human tumor tissues were processed and analyzed. The experimental study found that H<sub>2</sub>O<sub>2</sub> caused vacuolization of neuronal tissue in mouse brain tissues, with a mean depth of damage of 343.7 ± 39.7 μm after 2 min and 460.1 ± 36.4 μm after 10 min exposure to H<sub>2</sub>O<sub>2</sub> 3% (<i>p</i> < 0.001). In human brain tissues, vacuolization was detected in sections exposed to H<sub>2</sub>O<sub>2</sub> 1.5% and 3%, with a mean depth of damage of 543.8 ± 304.5 μm and 859.0 ± 379 μm (<i>p</i> = 0.003). In the bipolar coagulation group, the mean depth of neuronal damage, of 2504 ± 1490 μm, was nearly three times greater than that in the H<sub>2</sub>O<sub>2</sub> group (<i>p</i> < 0.001). Similar results were observed in human tumor tissues as well. <b>Conclusions</b>: H<sub>2</sub>O<sub>2</sub> seems to cause less local damage on neuronal and tumor cells than conventional bipolar cauterization, suggesting it as a good alternative to be used for hemostasis and marginal tumor cell treatment. However, due to its potential risk for embolism, H<sub>2</sub>O<sub>2</sub> should be used with caution. |
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| ISSN: | 1424-8247 |