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Is There Still a Place for the Use of Hydrogen Peroxide in Neurosurgery?

Year: 2026

Type: article

Abstract: Hydrogen peroxide (H2O2) has been used in neurosurgery for over a century as a hemostatic and antimicrobial agent. Despite its long history, its role in modern neurosurgical practice remains controversial due to significant safety concerns. This review examines the chemical and biological mechanisms of H2O2, its clinical applications in neurosurgery, associated risks, including gas embolism and neurotoxicity, and current best practice recommendations. While H2O2 demonstrates efficacy for hemostasis and infection control, the availability of safer alternatives and the risk of potentially fatal complications, particularly venous oxygen embolism and cardiovascular collapse, suggest that routine use is difficult to justify. Contemporary evidence supports a highly restrictive approach, with a strong trend toward replacing H2O2 entirely with saline irrigation and modern hemostatic techniques.

Source: Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery

DOI: 10.1055/s-0046-1829325

Authors: Samuel Pedro Pereira Silveira, Carlos Umberto Pereira, Roberto Alexandre Dezena

Institutions: Universidade Federal do Triângulo Mineiro, Universidade Federal de Sergipe

Language: English

Topic: Hemostasis and retained surgical items

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7221752089

FWCI:

Cites: 42

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