The American surgeon
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The American surgeon · May 1995
Randomized Controlled Trial Clinical TrialInteraction of vecuronium with piperacillin or cefoxitin evaluated in a prospective, randomized, double-blind clinical trial.
Interactions between beta-lactam antibiotics, particularly acylaminopenicillins, and vecuronium, a widely used muscle relaxant, leading to prolonged neuromuscular blockade have been reported in studies of experimental animals and in a few clinical case reports. In the clinical reports, however, confounding factors always existed. A clinical trial to evaluate interactions between vecuronium and cefoxitin or piperacillin was conducted. ⋯ Cefoxitin and piperacillin administered pre- or intra-operatively are not associated with clinically important prolongation of muscle relaxation induced by vecuronium. The potential for prolongation of neuromuscular blockade induced by vecuronium through concomitant administration of piperacillin or cefoxitin as antibiotic prophylaxis was investigated in a clinical trial of 30 patients having major abdominal operations. Quantitative measurement of neuromuscular blockade was done using the electromyographic twitch response to a supramaximal current stimulus.