Abstract
Summary The monoquaternary aminosteroidal compound, vecuronium bromide, is a potent non-depolarizing neuromuscular blocking drug with a duration of action which is 2–3 times shorter than that of pancuronium. Spontaneous recovery from muscle paralysis is predictably rapid and there is little evidence of cumulative effect following its administration over several hours by multiple injections or continuous infusion. When appropriate, neuromuscular transmission can be readily restored by anticholinesterase agents. Vecuronium is free from significant cardiovascular side-effects and, when twice the recommended intubating dose is given, the blood histamine levels remain within normal limits. It would appear that the drug is rapidly cleared from the plasma, mainly as a result of hepatic uptake and consequent biliary excretion. Renal mechanisms are of much less importance in the elimination and therefore, since the neuromuscular blockade is not prolonged, there is no contraindication to the use of this relaxant in patients with renal impairment. In comparison with the established neuromuscular blocking drugs, vecuronium would seem to represent a significant advance in that controlled relaxation can be readily maintained during surgical procedures extending in duration from some 20 minutes to many hours, without risk of prolonged recovery or unwanted side-effects.
Published Version
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