Korean J Anesthesiol.  2006 Dec;51(6):727-732. 10.4097/kjae.2006.51.6.727.

Effects of Vancomycin on the Neuromuscular Blockade of Vecuronium, Rocuronium and Atracurium in Rat Phrenic Nerve-Hemidiaphragm Preparation

• Kim SI
• Han CY
• Jung HS
• Lee JS
• Ok SY
• Kim SC

• KMID: 2243609
• DOI: http://doi.org/10.4097/kjae.2006.51.6.727

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.

Keyword

atracurium; drug interaction; neuromuscular blockade; rocuronium; vancomycin; vecuronium

MeSH Terms

Animals
Atracurium*
Colon, Sigmoid
Drug Interactions
Humans
Neuromuscular Blockade*
Orthopedic Procedures
Rats*
Vancomycin*
Vecuronium Bromide*
Atracurium
Vancomycin
Vecuronium Bromide