Since Pridgeon's1 description in 1956 of respiratory depression after intraperitoneal administration of neomycin, surgeons and anesthesiologists have become increasingly aware of this problem. Numerous additional reports have since been added to the literature.2
Experimental work in animals by Pittinger and Long3 has shown that neomycin exerts a curare-like action at the myoneural junction so that a complete or partial paralysis ensues. It also has been demonstrated that this neuromuscular blocking action was potentiated by ether and muscle relaxants but could be antagonized by neostigmine and calcium.4
Reversal of apnea, by neostigmine therapy, after intraperitoneal administration of neomycin was described in the case report by Middleton and associates.2e However, this patient during surgery also received a muscle relaxant, succinylcholine, which may have been responsible for the postoperative respiratory depression. Apnea due to succinylcholine occasionally responds to neostigmine.5 All the other patients in the cases reviewed
Jones WPG. CALCIUM TREATMENT FOR INEFFECTIVE RESPIRATION RESULTING FROM ADMINISTRATION OF NEOMYCIN. JAMA. 1959;170(8):943–944. doi:10.1001/jama.1959.63010080001010
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: