DEAFNESS AND PROLONGED NEUROMUSCULAR BLOCKADE FOLLOWING SINGLE-DOSE PERITONEAL NEOMYCIN IRRIGATION

Purpose: A case of deafness is reported in a patient undergoing bilate ral nephrectomy after single irrigation of the peritoneal cavity with a neomycin containing solution for surgical prophylaxis. Clinical Feat ures: in this patient, profound, late-postoperative deafness was heral ded by prolonged neuromuscular blockade and respiratory insufficiency. Additional risk factors for ototoxicity in this particular patient in cluded the presence of end-stage renal disease requiring daily periton eal dialysis and, possibly the concomitant use of clonazepam and clind amycin. Conclusions: Antibiotic irrigation solutions containing neomyc in may produce unwanted adverse systemic effects of deafness and prolo nged neuromuscular blockade, even with only brief application within t he peritoneal cavity. Concurrent end-stage renal disease, visceral inf lammation from chronic dialysis and laparotomy, and the concomitant us e of other medications may have contributed to these unwanted effects.