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vecuronium

vecuronium

introduction

  • a non-depolarising competitive acetylcholine antagonist at nicotinic receptors
  • the most commonly used non-depolarising neuromuscular blocking agent (NMBA) in the ED for maintenance of paralysis in intubated patients.
  • as with other non-depolarising NMBAs, its actions can be reversed with neostigmine (0.06 to 0.08 mg/kg IV) after approximately 40 percent of neuromuscular function has returned

dose

  • usual maintenance bolus iv doses: 0.02 to 0.04 mg/kg to max. adult dose 10mg as needed (usually every 30min or so)
  • duration of action 25-40min

usage as an induction NMBA

  • vecuronium or rocuronium can be used at induction if suxamethonium is contra-indicated or not desired.
  • a priming dose of 0.01 mg/kg is administered three minutes before an increased intubating dose of 0.15 mg/kg.
  • used in this way, vecuronium achieves intubation level paralysis in approximately 75 to 90 seconds

precautions

  • Ensure adequate anaesthesia, sedation; neuromuscular disease incl myasthenia gravis; prior poliomyelitis; factors predisposing to residual curarisation; hepatobiliary, renal (incl failure), CV disease; electrolyte, acid/ base, circulatory disturbances; hypoproteinaemia; dehydration; acidosis; hypercapnia; cachexia; hypothermia; obesity; oedema; burns; prolonged use (monitor neuromuscular transmission); hypersensitivity to other muscle relaxants; elderly; pregnancy, lactation, infants
vecuronium.txt · Last modified: 2009/03/18 18:07 (external edit)