Summary
The neuromuscular block produced by neomycin is unique. Despite nearly complete blockade of the twitch the tetanus is not blocked and does not fade. The pathognomonic post-tetanic exhaustion has not been reported previously. Anti-cholinesterases and calcium antagonize the block, but the antagonism may not be complete. Genuine antagonizes the block in the cat, but its clinical value has not been tested. These characteristics of neuromuscular block by neomycin strongly suggest respiratory support and sedation to decrease the respiratory drive, rather than attempts at antagonism, as the rational management of patients suffering from toxic paralysis due to neomycin.
Résumé
Les caractéristiques du bloc neuromusculaire de la Néomycine furent étudiées sur une préparation “nerf sciatique-muscle tibial antérieur” de chat. Le bloc neuromusculaire de la Néomycine (ED 50 = 39 ± 8 mg/kg) est différent du bloc neuromusculaire de la d-tubocurarine. Les contractions tétaniques ne furent pas diminuées par rapport aux valeurs contrôles malgré la suppression du “twitch.” La série de quatre contractions (2 Hz pendant 2 secondes) et le tétanos (50 Hz pendant 5 secondes) ne montrent pas d’évanescence. Les “twitch” (= secousses) posttétaniques furent constamment diminuées et ce d’une façon marquée, à la suite d’une brève période de facilitation post-tétanique d’une durée de 15 secondes. Un bloc de 50 pour cent put être transformé en un bloc de 100 pour cent pour 5 à 15 minutes par un tétanos de 50 Hz d’une durée de 5 secondes. L’antagonisme par les anticholinestérasiques (édrophonium, néostigmine, pyridostigmine) et par le calcium fut incomplet chez la plupart des chats. Le monoacétate de genuine antagonise complètement le bloc chez tous les chats testés. Ces résultats peuvent avoir des implications cliniques dans le diagnostic et le traitement des patients atteints de paralysie toxique secondaire à la néomycine et suggèrent que l’assistance respiratoire et la sédation plutôt qu’un anticurare sont des traitements de choix.
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This paper has been presented in part at the American Society of Anaesthesiologists Meeting (Chicago), October 11–15, 1975. An abstract has appeared in its monograph Abstracts of Scientific Papers. P. 199–200.
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Lee, C., Chen, D., Barnes, A. et al. Neuromuscular block by neomycin in the cat. Canad. Anaesth. Soc. J. 23, 527–533 (1976). https://doi.org/10.1007/BF03005981
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DOI: https://doi.org/10.1007/BF03005981