Vecuronium is mainly used as an adjuvant in surgical procedures conducted under general anesthesia, to facilitate endotracheal intubation and to provide muscle relaxation during skeletal surgery or mechanical ventilation.
It is used on patients of all ages: babies, infants, children, adolescents and adults.
What is Vecuronium?
Vecuronium is a drug that belongs to the group of muscle relaxants. More precisely, it is defined as "competitive non-depolarizing neuromuscular blocker."
Also known as "competitive neuromuscular blocking agent", it acts on the peripheral nervous system, interrupting the neuromuscular transmission by competing with the activity of the neurotransmitter acetylcholine, and thereby reducing the response of acetylcholine receptors issued in following the nervous impulse.
In addition to Vecuronium, tubocurarine (which is the founder of the non-depolarizing muscle relaxants), Alcuronium, gallamine triethiodide, Metocurine, Pancuronium, Atracurium, and Cisatracurium are also part of the same group of drugs. More specifically, the non-depolarizing neuromuscular blockers are chemically divisible into two categories: the medications (Rocuronium, Rapacuronium, Pipecuronium, Pancuronium, Vecuronium) and derivatives (Tubocurarine, Doxacurium, Atracurium, Cisatracurium, Mivacurium).
Although currently classified as "muscle relaxant", the Vecuronium may also be classified as a "numbing agent".
How should Vecuronium be taken?
Vecuronium is available in the form of ampoules containing the drug powder, which must be dissolved in distilled water before administration. The administration is carried out intravenously, with a bolus injection or continuous infusion.
Side effects associated with Vecuronium
There are several side effects that can result from the use of this drug:
- General disorders: allergic reactions of various types;
- Cardiovascular disturbances: hypotension, hypertension, vasodilation, tachycardia, bradycardia, hypoxemia ;
- Respiratory disorders: dyspnea, bronchospasm, laryngospasm, asthma;
- Musculoskeletal disorders: muscle weakness;
- Dermatological disorders: rash, urticaria, rash, reactions at the injection site;
Contraindications and warnings associated with the use of Vecuronium
Particular attention should be paid to the administration of this drug in patients with known or suspected hypersensitivity to the product. In addition, it should only be administered by experienced staff.
Similar to all other neuromuscular blocking agents, the dosage of Vecuronium should be individualized for each patient. Some conditions – mostly due to severe electrolyte disturbances, altered blood pH or dehydration – can increase side effects: hypokalemia, hypermagnesemia, hypocalcaemia, hypoproteinaemia, dehydration, acidosis, and hypercapnia, cachexia.
Medical personnel should pay particular attention regarding any concomitant medications taken by the patient prior to administration of the drug. Some drugs, in fact – as the volatile halogenated anesthetics, corticosteroids, different types of antibiotics, diuretics and beta-blockers – can increase the effects, and concomitant use of other substances – such as phenytoin and carbamazepine – usually tend to reduce efficacy.
Lastly, the use of Vecuronium during pregnancy and breastfeeding is only permitted if the physician determines that the benefits for the mother outweigh any health risks to the child's health.
