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Neuromuscular block by neomycin in the cat
Canadian Anaesthetists' Society Journal
|September 1, 1976
Summary
Neomycin causes a unique neuromuscular block that spares tetanus but leads to exhaustion. Management should focus on respiratory support and sedation, not antagonism, for neomycin-induced paralysis.
Area of Science:
- Pharmacology
- Neuroscience
- Anesthesiology
Background:
- Neomycin is an aminoglycoside antibiotic.
- Aminoglycosides can cause neuromuscular blockade.
- The specific characteristics of neomycin-induced neuromuscular blockade are not fully understood.
Purpose of the Study:
- To characterize the unique neuromuscular blockade produced by neomycin.
- To investigate potential antagonisms of neomycin-induced neuromuscular blockade.
- To determine the optimal management strategy for neomycin-induced toxic paralysis.
Main Methods:
- Electromyography was used to assess neuromuscular function.
- The effects of neomycin on twitch and tetanus responses were evaluated.
- Antagonism of the blockade by anticholinesterases, calcium, and germine was studied.
Main Results:
- Neomycin produced near-complete blockade of twitch responses.
- Tetanus responses were not blocked and did not fade.
- Pathognomonic post-tetanic exhaustion was observed.
- Anticholinesterases and calcium partially antagonized the block.
- Germine antagonized the block in cats, but clinical data is lacking.
Conclusions:
- Neomycin-induced neuromuscular blockade has unique features, including preserved tetanus and post-tetanic exhaustion.
- Antagonism of neomycin-induced blockade may be incomplete.
- Respiratory support and sedation are recommended for managing neomycin-induced toxic paralysis, rather than antagonism.