| Effects of Vancomycin on the Neuromuscular Blockade of Vecuronium, Rocuronium and Atracurium in Rat Phrenic Nerve-Hemidiaphragm Preparation. |
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Soon Im Kim, Chang Yoon Han, Ho Soon Jung, Jeong Seok Lee, Si Young Ok, Sun Chong Kim |
1Department of Anesthesiology and Pain Medicine, Colleges of Medicine, Soonchunhyang University, Seoul, Korea. soonnim@hosp.sch.ac.kr
2Department of Medicine, Graduate School, Soonchunhyang University, Asan, Korea. |
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| Abstract |
BACKGROUND
Vancomycin is frequently used as a prophylactic antibiotic in patients undergoing cardiac and orthopedic surgical procedures. However, the interactions of vancomycin with non-depolarizing muscle relaxant have not yet been reported on. Therefore, we studied the effects of vancomycin on the neuromuscular block of vecuronium, rocuronium and atracurium in vitro.
METHODS
Square wave, 0.1 Hz supramaximal stimuli were applied to the phrenic nerve-hemidiaphragm preparation of the rat and the twitch height response was recorded. We measured cumulative concentration response curves of vecuronium, rocuronium or atracurium, respectively, and also those of the rats that were pretreated with vancomycin (20 microgram/ml). The EC50 and EC95 of these muscle relaxants alone and those of the rats pretreated with vancomycin were calculated with using an inhibitory sigmoid Emax model.
RESULTS
Vancomycin alone did not depress the twitch height.
The pretreated vancomycin (20 microgram/ml) did not affect the EC50 and EC95 of vecuronium or rocuronium, but it significantly reduced the EC50 and EC95 of atracurium (P < 0.05).
CONCLUSIONS
Vancomycin itself does not have neuromuscular blocking properties. Vancomycin does not affect the neuromuscular blockade induced by vecuronium or rocuronium, but it significantly enhances the neuromuscular blockade induced by atracurium. |
| Key Words:
atracurium; drug interaction; neuromuscular blockade; rocuronium; vancomycin; vecuronium |
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