Non-Depolarising Neuromuscular Blocking Agent
Pregnancy: Use with caution — safe for obstetric use
Vecuronium
Brand names: Norcuron
Adult dose
Dose: Intubation: 0.1 mg/kg; Maintenance: 0.02–0.03 mg/kg
Route: IV
Frequency: Bolus; repeat as required
Max: Titrated to TOF
Intermediate-duration NMB. Minimal cardiovascular effects — useful in cardiac surgery. Supplied as lyophilised powder; must be reconstituted. Largely superseded by rocuronium in UK practice.
Paediatric dose
Dose: 0.1 mg/kg
Route: IV
Frequency: As required
Max: Titrated to effect
Same dosing as adults. Infants (7 weeks–1 year) are more sensitive — use lower end of range.
Dose adjustments
Renal
Caution — some renal excretion; prolonged block possible in renal failure. Monitor TOF.
Hepatic
Prolonged duration in hepatic failure — reduce maintenance doses.
Paediatric weight-based calculator
Same dosing as adults. Infants (7 weeks–1 year) are more sensitive — use lower end of range.
Clinical pearls
- Reversible with sugammadex (aminosteroidal NMB) or neostigmine + glycopyrrolate (at TOF ≥2 twitches)
- Preferred in cardiac surgery due to haemodynamic neutrality
- Avoid prolonged infusions in ICU — risk of critical illness myopathy/polyneuropathy
Contraindications
- Hypersensitivity to vecuronium
Side effects
- Anaphylaxis (rare)
- Prolonged block in organ failure
- ICU-acquired weakness with prolonged infusion
Interactions
- Volatile anaesthetics (potentiate)
- Aminoglycosides (potentiate)
- Magnesium (potentiate)
Monitoring
- Quantitative TOF monitoring
- Clinical reversal assessment before extubation
Reference: BNFc; BNF 90; Miller's Anaesthesia 9th Ed; AAGBI Guidelines. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs