Vecuronium
💉 Vecuronium is a non-depolarising muscle relaxant.
⏳ Effect lasts longer than suxamethonium and is commonly used for intubation and mechanical ventilation when prolonged paralysis is needed.
⚠️ Must only be given once the patient is fully anaesthetised and airway secured.
📖 About
- Always check the BNF link here for updated prescribing advice.
- Non-depolarising neuromuscular blocker from the aminosteroid group.
- Intermediate onset and duration, commonly used in theatres and ICU.
⚙️ Mode of Action
- Competitive antagonist at nicotinic acetylcholine receptors at the neuromuscular junction.
- Prevents depolarisation of skeletal muscle endplates → paralysis.
- Action reversed by neostigmine or sugammadex (selective binding agent).
💊 Indication/Dose (Adults)
- Intubation: 0.08–0.1 mg/kg IV (80–100 micrograms/kg).
- Maintenance: 0.02–0.03 mg/kg IV bolus, titrated to response.
- Special case: Caesarean section – max 0.1 mg/kg IV.
🔗 Interactions
- See BNF for full list (potentiated by aminoglycosides, magnesium, lithium, certain anaesthetic agents).
⚠️ Cautions
- Burns (resistance due to receptor upregulation).
- Electrolyte or fluid disturbances (e.g., hypokalaemia, hypocalcaemia).
- Hypothermia (prolongs effect).
- Myasthenia gravis (markedly increased sensitivity).
- Heart disease → risk of arrhythmias.
⛔ Contraindications
- See BNF (generally avoid in hypersensitivity or unstable clinical situations).
💥 Side Effects
- Flushing and hypotension (rare, mild histamine release).
- Bronchospasm and hypersensitivity reactions.
- Tachycardia.
💡 Clinical Pearls
- Onset: ~2–3 minutes; Duration: 20–40 minutes.
- Metabolised hepatically and excreted renally → prolonged effect in liver/renal impairment.
- Less histamine release compared to atracurium → more cardiovascularly stable.
- Often used for ICU infusions when long-term paralysis is needed.
📚 References
