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Anesth Analg 2003;96:750-754
© 2003 International Anesthesia Research Society

ANESTHETIC PHARMACOLOGY

The Effect of Vecuronium Is Enhanced by a Large Rather than a Modest Dose of Gentamicin as Compared with No Preoperative Gentamicin

Zohar A. Dotan, MD*, Rene Hana, MD{dagger}, Daniel Simon, MD{dagger}, Daniel Geva, MD{ddagger}, Reuven A. Pfeffermann, MD{dagger}, and Tiberiu Ezri, MD§

*Department of Urology, Sheba Medical Center, Ramat Gan; Departments of {dagger}General Surgery and {ddagger}Anesthesia, Kaplan Medical Center, Rehovot; and §Department of Anesthesia, Wolfson Medical Center, Holon, Israel (Affiliated with *§Sackler School of Medicine, Tel Aviv and {dagger}{ddagger}Hadassah Medical School, Jerusalem, Israel)

Address correspondence to Tiberiu Ezri, MD, Department of Anesthesia, Wolfson Medical Center, Holon 58100, Israel. Address e-mail to tezri{at}netvision.net.il

We compared the effect of two doses of gentamicin versus no gentamicin (NG) given before surgery on the neuromuscular relaxant effect of vecuronium. Seventy patients (intraabdominal procedures) were randomly allocated to receive preoperative large-dose (4 mg/kg) gentamicin (LD), a modest dose (1.2 mg/kg) of gentamicin (MD), or NG. No more than one dose of gentamicin was given before the vecuronium administration. Serum gentamicin levels, the time for 25% recovery of the first twitch in the train-of-four after a bolus of vecuronium, and the time from cessation of the vecuronium infusion to extubation of the trachea were estimated. Serum gentamicin levels were higher (P < 0.001) for LD than MD. The time for 25% recovery of the first twitch after the vecuronium bolus was slightly longer with LD than MD (P = 0.06) and longer in LD than NG (P = 0.001) (42.9 ± 23.6 min versus 36.2 ± 17 min and 27.4 ± 9 min, respectively). The time to extubation was similar with LD and MD and longer for LD than NG (P = 0.008) (34.7 ± 19.2 min versus 27.4 ± 19.3 min and 19.4 ± 10.1 min, respectively). The differences in these times were insignificant between MD and NG. Gentamicin administered as a LD rather than MD enhanced the neuromuscular blockade of vecuronium as compared with NG given before surgery.

IMPLICATIONS: We demonstrated that the neuromuscular relaxant effect of vecuronium is enhanced by a large (4 mg/kg) rather than a modest (1.2 mg/kg) dose of gentamicin as compared with no gentamicin given before surgery.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2003 by the International Anesthesia Research Society.