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Indication & Dosage |
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| Intravenous |
| FACILITATION OF ENDOTRACHEAL INTUBATION AND PROVISION OF MUSCLE RELAXATION IN GENERAL ANAESTHESIA DURING SURGICAL PROCEDURES |
| Child:
< 5 mth: Initially, 10-20 mcg/kg, increased if necessary according to response. > 5 mth: initially, 80-100 mcg/kg given as inj; alternatively, 30-50 mcg/kg after clinical recovery from neuromuscular blockade of suxamethonium. Max in caesarean and neonatal surgery: 100 mcg/kg. Maintenance in prolonged procedure: 10-15 mcg/kg.
Elderly: Dose reduction may be needed |
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| Intravenous |
| FACILITATION OF ENDOTRACHEAL INTUBATION AND PROVISION OF MUSCLE RELAXATION IN GENERAL ANAESTHESIA DURING SURGICAL PROCEDURES |
| Adult:
Initially, 80-100 mcg/kg given as inj; alternatively, 30-50 mcg/kg after clinical recovery from neuromuscular blockade of suxamethonium; max in caesarean and neonatal surgery: 100 mcg/kg; maintenance in prolonged procedure: 10-15 mcg/kg. Alternatively, as continuous infusion: A bolus dose of 40-100 mcg/kg, start continuous infusion when neuromuscular block starts to recover; adjust infusion rate between 0.8 to 1.4 mcg/kg/min. |
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| Precautions |
Pregnancy, lactation, elderly. Renal and hepatic impairment. Increase in onset time in conditions associated with prolonged circulation time (e.g. CV disease, oedema). Neuromuscular disease e.g. myasthenia gravis, Eaton-Lambert syndrome or after poliomyelitis. Hypothermia, burns patients. Decrease dose in obese patients, taking into account lean body-mass. Correct severe electrolyte disturbances, altered blood pH, dehydration where possible before vecuronium admin. Do not use potentially dangerous machinery or drive a car within 24 hr after full recovery from the neuromuscular blocking action of vecuronium. Do not admin vecuronium unless facilities for intubation, artificial respiration, oxygen therapy and agents for neuromuscular reversal are immediately available. |
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Potentially Life-threatening
Adverse Drug Reactions |
Muscle weakness, paralysis, muscle atrophy (after long term use), hypersensitivity reactions e.g urticaria and erythema. |
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| Adverse Drug Reactions |
Anaphylaxis, respiratory failure, apnoea. |
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| 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, β-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. |
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