Vecuronium Bromide
Indications
Vecuronium Bromide is used for:
General anaesthesia, Skeletal muscle relaxation
Adult Dose
Intravenous
Muscle relaxant in general anaesthesia; Facilitate endotracheal intubation; Facilitate mechanical ventilation in intensive care
Adult: Initially, 80-100 mcg/kg by inj. Maintenance: 20-30 mcg/kg by inj or as continuous infusion at 0.8-1.4 mcg/kg/min.
Surgical procedures after intubation w/ suxamethonium: 30-50 mcg/kg.
Caesarean section: <100 mcg/kg.
Surgery under halothane and neurolept anaesth: Initially, 150-300 mcg/kg.
Child Dose
Intravenous
Muscle relaxant in general anaesthesia; Facilitate endotracheal intubation; Facilitate mechanical ventilation in intensive care
Child: <4 mth Initial test dose: 10-20 mcg/kg, w/ increments according to response;
> 4 month: 80-100 mcg/kg by inj. Maintenance: 20-30 mcg/kg by inj or as continuous infusion at 0.8-1.4 mcg/kg/min.
Neonatal surgery: <100 mcg/kg.
Renal Dose
Administration
Contra Indications
Hypersensitivity to vecuronium or bromide.
Precautions
Patient w/ CV disease, oedema, neuromuscular disease, previous poliomyelitis, burn injury, severe electrolyte disturbances, altered blood pH, dehydration; obese patient. Hepatic and renal impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor BP, heart rate; peripheral nerve stimulation.
Pregnancy-Lactation
Pregnancy Category: C
Lactation: Not known if excreted in breast milk; effect on nursing infant not known; used during pregnancy only when clearly needed
Interactions
Increases neuromuscular blockade with volatile anaesthetic agents (halothane, ether, enflurane, isoflurane, methoxyflurane, propofol and cyclopropane), fentanyl, other non-depolarising muscle relaxants, prior admin of succinylcholine, tetracyclines, polymyxins, diuretics, thiamine, MAOIs, bacitracin, colistin, sodium colistimethate, acylaminopenicillins, aminoglycoside antibiotics, high dose metronidazole, protamine, beta-adrenergic blocking agents, calcium antagonists e.g. verapamil, and Mg. Decreased neuromuscular blockade with anticholinesterases, prior chronic admin of corticosteroids, phenytoin, carbamazepine, noradrenaline, azathioprine, theophylline, calcium chloride.
Adverse Effects
Side effects of Vecuronium Bromide :
Skeletal muscle weakness or paralysis, resp insufficiency or apnoea, bronchospasm, hypotension, tachycardia, acute urticaria, erythema, minimal induration, redness, itching, CV effects (e.g. changes in heart rate, cardiac index), myopathy.
Potentially Fatal: Anaphylaxis.
Mechanism of Action
Vecuronium bromide inhibits depolarisation by blocking acetylcholine from binding to receptors on motor endplate.