Gilbert T B, Jacobs S C, Quaddoura A A
Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.
Can J Anaesth. 1998 Jun;45(6):568-70. doi: 10.1007/BF03012710.
A case of deafness is reported in a patient undergoing bilateral nephrectomy after single irrigation of the peritoneal cavity with a neomycin containing solution for surgical prophylaxis.
In this patient, profound, late-postoperative deafness was heralded by prolonged neuromuscular blockade and respiratory insufficiency. Additional risk factors for ototoxicity in this particular patient included the presence of end-stage renal disease requiring daily peritoneal dialysis and, possibly, the concomitant use of clonazepam and clindamycin.
Antibiotic irrigation solutions containing neomycin may produce unwanted adverse systemic effects of deafness and prolonged neuromuscular blockade, even with only brief application within the peritoneal cavity. Concurrent end-stage renal disease, visceral inflammation from chronic dialysis and laparotomy, and the concomitant use of other medications may have contributed to these unwanted effects.
报告1例患者在腹膜腔单次灌注含新霉素溶液进行手术预防后接受双侧肾切除术时出现耳聋的病例。
该患者术后出现严重的迟发性耳聋，术前有长时间的神经肌肉阻滞和呼吸功能不全。该特定患者耳毒性的其他危险因素包括存在需要每日进行腹膜透析的终末期肾病，以及可能同时使用氯硝西泮和克林霉素。
含新霉素的抗生素灌洗溶液可能会产生不良的全身性副作用，如耳聋和延长神经肌肉阻滞时间，即使仅在腹膜腔内短暂应用也可能如此。终末期肾病、慢性透析和剖腹手术引起的内脏炎症以及同时使用其他药物可能导致了这些不良影响。
