Hydrogen peroxide is a strong oxidant commonly used by doctors, which has the functions of disinfection, antiseptic and cleaning. It is often used clinically to clean wounds: whether it is debridement by plastic surgeons, irrigation of abscesses and fistulas by surgeons, or even periodontal cleaning by dentists.
However, did you know that if hydrogen peroxide is used improperly, it will cause serious injury or even death to the patient!
In 2015, the UK Medicines and Health Products Regulatory Agency (MHRA) released anquan information, saying that the use of hydrogen peroxide during surgery can lead to life-threatening or fatal cases of gas embolism, and therefore warned that hydrogen peroxide should not be used during surgery, and that hydrogen peroxide should not be used during surgery. Apply to closed body cavities or deep, large wounds. Since hydrogen peroxide rapidly decomposes into water and oxygen upon contact with tissue, the large amount of oxygen produced can cause gas embolism if the reaction takes place in an enclosed space
- Gas embolism caused by flushing periodontal pockets
- Gas embolism caused by flushing of periodontal pockets
Patient female, 37 years old, teacher. The patient was diagnosed with chronic apical periodontitis in the stomatology department 4 days before admission, with fever and toothache. During flushing of the palatal periodontal pocket of the right maxillary diyi molar with 3-point hydrogen peroxide solution, he suddenly became confused and incontinent, and within 4 hours his condition deteriorated sharply, developing coma and status epilepticus.
At that time, an MRI examination of the head was performed in the emergency department, and the results showed that the basal ganglia, bilateral, and the right side of the anterior horn of the lateral ventricle were multiple patchy abnormal signals, and the right frontotemporal lobe was suspicious. Arterial and distal posterior cerebral artery blood flow signals were diminished, with soft tissue swelling in the right maxillary region and abnormal signal in the right maxillary sinus.
Nervous system physical examination after admission: moderate coma, eyes staring continuously to the right, left muscle strength grade 0, left upper extremity flexion spasm, left lower extremity stiffness, right lower extremity voluntary movement, normal muscle tone, positive bilateral cone tract signs, neck There was no resistance to flexion, and meningeal irritation was negative. “Secondary epilepsy, initial diagnosis of intracranial infection? Soft tissue infection of the right maxillofacial region”.
After admission, the patients were treated with antibiotics and anti-inflammatory, high-dose hormone shock therapy, anticoagulation to improve cerebral blood circulation, dehydration to reduce intracranial pressure, multivitamins, oral care, incision and drainage of the right oral and palatine mucosa, mouthwash, external application, etc. topical treatment.
Fortunately, after 19 days in the hospital, he recovered and returned to normal.