Table 1.
Description of the cases presented with dysrhythmia related to the use of H2O2
| Case | Age (years)/Gender | Preoperative medications | Type of surgery | Requiring intervention | Possible cause |
|---|---|---|---|---|---|
| 1 | 60/M | Yes – beta blockers | Acute subdural hematoma removal – fronto temporo parietal craniotomy | No | TCR – chemical stimulation to trigeminal afferents |
| 2 | 67/M | No | Chronic subdural hematoma removal – fronto temporo parietal cranitomy | No | TCR – chemical stimulation to trigeminal afferents |
| 3 | 16/F | No | Pituitary adenoma – pterional craniotomy– | No | TCR Anterior hypothalamus stimulation |
| Exothermic reaction of H2O2 | |||||
| 4 | 15/M | No | Craniopharyngeoma – right frontal craniotomy | No | Mechanical stimulation of anterior hypothalamus |
| Exothermic reaction of H2O2 | |||||
| 5 | 12/M | No | Posterior fossa surgery for cerebellar tumor – Midline suboccipital craniectomy | No | Mechanical stimulation of vital centres Thermal irritation from the exothermic reaction from H2O2 |
TCR = trigemino-cardiac reflex, H2O2 = hydrogen peroxide