Aminosteroid non-depolarising NMB
Vecuronium bromide
Brand names: Norcuron
Adult dose
Dose: Intubation: 80–100 micrograms/kg IV. Maintenance: 20–30 micrograms/kg or 0.8–1.4 micrograms/kg/min
Route: IV
Frequency: per induction
Dose adjustments
Renal
Use cautiously
Clinical pearls
- Cardiovascular stability; reversible with sugammadex
- Largely superseded by rocuronium/atracurium/cisatracurium
Contraindications
- Hypersensitivity
Side effects
- Prolonged blockade in renal/hepatic impairment
- Anaphylaxis
- Bradycardia (with opioids)
- Histamine release minimal
Interactions
- Aminoglycosides
- Magnesium
- Volatile anaesthetics
- Cholinesterase inhibitors
Monitoring
- Train-of-four
Reference: BNF; AAGBI; https://bnf.nice.org.uk/drugs/vecuronium-bromide/. Verify against your local formulary and the latest BNF before prescribing.