Vecuronium Bromide

General anaesthesia, Skeletal muscle relaxation

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.

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.

Hypersensitivity to vecuronium or bromide.

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.

C Pregnancy Category: C Lactation: Not known if excreted in breast milk; effect on nursing infant not known; used during pregnancy only when clearly needed

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.

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.

Vecuronium bromide inhibits depolarisation by blocking acetylcholine from binding to receptors on motor endplate.