흰쥐 횡격막 신경근 표본에서 Vancomycin이 비탈분극성 근이완제의 신경근 차단에 미치는 영향

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.