vecuronium bromide at a glance
Medicine class
Non-depolarising neuromuscular blocking agent
Usual role
Helps tracheal intubation and relaxes skeletal muscles during surgery under general anaesthesia
Administration
Given into a vein by, or under the supervision of, an experienced clinician
Breathing support
Ventilation is required until adequate spontaneous breathing returns
What is vecuronium bromide used for?
UK-licensed uses as an adjunct to general anaesthesia include:
Facilitating placement of a breathing tube into the trachea
Providing skeletal muscle relaxation during surgery in adults and children, including neonates and infants
How does vecuronium bromide work?
Vecuronium bromide competes with acetylcholine at nicotinic receptors where motor nerves meet skeletal muscle. This interrupts nerve-to-muscle signalling and causes temporary paralysis without the initial muscle twitching associated with depolarising blockers.
vecuronium bromide preparations and strengths
Injection
Route: Parenteral
Strengths: 10 mg
How to take vecuronium bromide
This is not self-administered. The powder is reconstituted and given into a vein as an injection or infusion by an experienced clinical team during anaesthesia, with sedation, pain relief, breathing support and neuromuscular monitoring as appropriate.
Food and drink do not affect its administration; follow the hospital’s fasting instructions for anaesthesia.
The reconstituted solution must be clear and free from particles.
Vecuronium bromide must not be mixed with thiopental; shared intravenous lines require appropriate flushing where compatibility is uncertain.
vecuronium bromide side effects
Common or expected effects
- Prolonged neuromuscular block, muscle weakness or delayed recovery
- Changes in vital signs, including low blood pressure or a fast heart rate
Get urgent medical advice
- Severe allergic reaction, with bronchospasm, swelling, hives, low blood pressure, collapse or shock
- Prolonged paralysis causing inadequate breathing or apnoea
- Persistent muscle weakness or myopathy, particularly after prolonged intensive-care use with corticosteroids
vecuronium bromide in pregnancy
Pregnancy data are limited, so the anaesthetist should use vecuronium bromide only when the expected benefit justifies the potential risk. It has been studied during Caesarean section with little placental transfer reported. Magnesium sulfate can strengthen the block and make reversal less reliable, so the anaesthetic team must know if it is being used.
vecuronium bromide while breastfeeding
It is unknown whether vecuronium bromide passes into human milk. The clinician should weigh the benefits of breastfeeding against the need for treatment and the full anaesthetic plan. Tell the anaesthetist that you are breastfeeding; most operations can be performed while breastfeeding continues.
vecuronium bromide interactions
The anaesthetist should review all recent medicines because several can change the depth or duration of paralysis.
Volatile inhaled anaesthetics
Can strengthen and prolong neuromuscular block and may make reversal with cholinesterase inhibitors less effective.
Suxamethonium and other neuromuscular blockers
May strengthen or weaken vecuronium’s effect depending on the medicine and order of administration.
Aminoglycoside, lincosamide, polypeptide and acylaminopenicillin antibiotics
Can increase or restart neuromuscular block, including after surgery.
Common questions about vecuronium bromide
Answers are fully visible for fast scanning and source review.
What is vecuronium bromide used for during surgery?
It temporarily paralyses skeletal muscles to help the anaesthetist place a breathing tube and to provide muscle relaxation during an operation.
Does vecuronium bromide put you to sleep?
No. It causes muscle paralysis but does not produce unconsciousness, amnesia or pain relief, so it is used with appropriate anaesthetic medicines.
Does vecuronium bromide stop breathing?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.