Indications
Vecuronium Bromide is a muscle relaxant used during general anaesthesia. It relaxes the muscles so that a breathing tube can be placed in the windpipe, makes surgery easier, and helps patients on a breathing machine in intensive care. It does not cause sleep or relieve pain, so it is always given with anaesthetic and pain relieving medicines.
How It Works
Nerves tell muscles to move by releasing acetylcholine at the junction between nerve and muscle. Vecuronium blocks the receptors for acetylcholine at this junction, so the muscles cannot contract and become temporarily limp. The effect wears off as the drug is cleared, or it can be reversed with medicines such as Neostigmine or Sugammadex.
Dosage and Administration
It is given only by an anaesthetist or trained doctor as an injection into a vein, in an operating theatre or intensive care unit with full breathing support. The dose depends on body weight and the length of the procedure and is set by the anaesthetist.
Interactions
- Inhaled anaesthetics, aminoglycoside antibiotics such as Gentamicin, Clindamycin, Magnesium, Lithium, Quinidine and some calcium channel blockers can strengthen and prolong its effect.
- Long term Phenytoin or Carbamazepine may shorten its effect.
- Corticosteroids used with it for long periods in intensive care may increase the risk of muscle weakness.
Contraindications
- Known allergy to Vecuronium or Bromide.
- It must not be used where facilities for breathing support are not available.
Side Effects
Because it is given under close monitoring, side effects are watched for by the anaesthetic team. Possible effects include prolonged muscle weakness, breathing difficulty after surgery, slow heartbeat, and, rarely, allergic reactions with rash, low blood pressure or wheezing.
After surgery, tell the nurse or doctor at once, or get urgent help, if you have trouble breathing or swallowing, cannot lift your head, or have marked weakness, double vision or swelling of the face or throat.
Pregnancy and Lactation
It is used during caesarean section and other surgery in pregnancy when the anaesthetist considers it appropriate. Breastfeeding can usually resume once the mother is awake and recovered from anaesthesia.
Precautions and Warnings
- Tell the anaesthetist about myasthenia gravis, other nerve or muscle diseases, liver or kidney disease, burns and any previous anaesthetic reactions.
- Salt and fluid imbalances, low potassium and low body temperature can prolong its effect.
Overdose
Overdose leads to prolonged paralysis and inability to breathe. It is managed by the anaesthetic team with breathing support and reversal medicines.
Therapeutic Class
Non depolarising neuromuscular blocking agent.
Storage
Hospital medicine: store as directed on the pack, below 25°C and away from light. Use the reconstituted solution as directed by the manufacturer.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.