Two Cases of adverse reactions of vancomycin administration in the perioperative period / 대한마취과학회지

ABSTRACT

Antibiotics are frequently administered for prophylaxis during anesthesia . Vaneomycin has increasingly become the antibiotic of choice due to the rising incidenee of resistant staphylococcal infections. Patients allergic to penicillin are candidates for vancomycin. Commonly reported adverse reactions of vancomycin include ; fever,chills, nausea, pain at the injection site, phlebitis, nephrotoxicity, ototoxicity, hypotension, cardiac arrest, broncho- spasm, noncardiogenic pulmonary edema and the so-called Red-Man's syndrome or Red Neck syndrome, Recently, we encountered two patients who had adverse reactions of vancomycin perioperatively. Vancomycin induced hypotension usually results from a negstive inotropic and vasodilator effect produced by a histamine-release phenomenon, which occurs most commonly with rapid intravenous infusion of the drug. Such a release of histarnine may also produce an acute urticarial flushing of the upper torso ("Red Neek syndrome"), pain and muscle spasm in the chest or parasternal muscles, which may mimic myocardial infarction. These effects usually abate promptly when the infusion of vancomycin is discontinued, and their resolution may be expedited by sdministration of an inotropic agent.