臭化ベクロニウム
Vecuronium Bromide
別名: Norcuron · Curlem · Rivecrum · Vecural · Org-NC-45 · Vecuronium bromide · Vecuronii bromidum
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Muscle relaxation during anesthesia | 0.1 mg/kg | IV | initially (after meperidine and/or acepromazine pre-op 30 minutes before); may give subsequent incremental doses of 0.04 mg/kg | — | 🌎 NA |
| Muscle relaxation during anesthesia | 10-20 micrograms/kg | IV | — | — | 🌎 NA |
| Muscle relaxation (CRI maintenance with propofol-fentanyl) | 0.2 mg/kg/hr | IV | CRI | — | 🌎 NA |
| Muscle relaxation (CRI maintenance with fentanyl-isoflurane or fentanyl-sevoflurane) | 0.1 mg/kg/hr | IV | CRI | — | 🌎 NA |
| Neuromuscular blockade (loading dose) | 0.1 mg/kg | IV | initially | Produces blockade for 25-30 min | 🌍 EU |
| Neuromuscular blockade (maintenance) | 0.03 mg/kg increments OR 0.1-0.2 mg/kg/h | IV | PRN or CRI | As needed during surgery | 🌍 EU |
| Reversal of neuromuscular blockade | 8 mg/kg | IV | once | Immediate | 🌍 EU |
- Muscle relaxation during anesthesia: Duration of action after initial dose averages 25 minutes.
- Neuromuscular blockade (loading dose): Lower loading dose of 0.05 mg/kg IV produces shorter duration (16-19 min).
- Neuromuscular blockade (maintenance): Repeated doses are relatively non-cumulative in healthy animals.
- Reversal of neuromuscular blockade: Dose for Sugammadex to reverse vecuronium-induced blockade.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| Muscle relaxation during anesthesia | 20-40 micrograms/kg (0.02-0.04 mg/kg) | IV | — | — | 🌎 NA |
| Neuromuscular blockade (loading dose) | 0.1 mg/kg | IV | initially | Produces blockade for 25-30 min | 🌍 EU |
| Neuromuscular blockade (maintenance) | 0.03 mg/kg increments OR 0.1-0.2 mg/kg/h | IV | PRN or CRI | As needed during surgery | 🌍 EU |
- Neuromuscular blockade (loading dose): Lower loading dose of 0.05 mg/kg IV produces shorter duration (16-19 min).
- Neuromuscular blockade (maintenance): Repeated doses are relatively non-cumulative in healthy animals.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
臭化ベクロニウムは、中時間作用型の合成アミノステロイド系非脱分極性神経筋遮断薬です。
主な臨床的特徴は以下の通りです：
- 手術の補助：主に全身麻酔の補助として使用され、深い骨格筋弛緩をもたらします。
- 処置の円滑化：気管挿管、人工呼吸、および精密な外科手術（眼科や整形外科手術など）を容易にするのに最適です。
- 心血管系の安定性：他の神経筋遮断薬とは異なり、心血管系への影響はごくわずかであり、通常ヒスタミン遊離を引き起こしません。
- 鳥類への使用：鳥類の虹彩には横紋肌が含まれているため、散瞳（瞳孔散大）を誘発するために局所的に使用されたことがあります。
重要な臨床的真珠（パール）：ベクロニウムには鎮痛、鎮静、または健忘作用は一切ありません。横隔膜を含むすべての骨格筋を麻痺させます。投与前および投与中は、患者が完全に麻酔され、意識がなく、陽圧人工呼吸を受けている必要があります。
作用機序
Vecuronium acts as a competitive antagonist at the nicotinic cholinergic receptors (nAChRs) located at the motor endplate of the neuromuscular junction.
- Mechanism: Vecuronium binds to the alpha subunits of the nAChR → prevents acetylcholine (ACh) from binding → inhibits depolarization of the muscle fiber → results in flaccid paralysis.
- Potency: It is highly potent, estimated to be equipotent to up to 3 times as potent as pancuronium on a weight basis, but with a shorter duration of action (approximately ⅓ to ½ as long).
安全性・警告
禁忌
- Known hypersensitivity to vecuronium or bromides
- Conscious or inadequately anesthetized animals
- Lack of facilities for positive pressure ventilation/mechanical ventilation
- Severe hepatic dysfunction (relative contraindication; atracurium preferred)
有害事象
- Profound, prolonged musculoskeletal paralysis (pharmacologic effect)
- Skeletal muscle weakness
- Respiratory arrest (if mechanical ventilation is not provided)
- Prolonged apnea (expected pharmacological effect)
- No cardiovascular effects or histamine release reported at clinical doses
注意事項
- Ventilation Required: Must only be used when facilities for intubation and mechanical ventilation are immediately available.
- Organ Dysfunction: Use with caution in patients with severe renal dysfunction. Lower doses may be necessary in patients with hepatic or biliary disease due to delayed clearance and prolonged recovery times.
- Myasthenia Gravis: Neuromuscular blocking agents should be used with extreme caution, if at all, in patients with myasthenia gravis (though one successful case in a dog has been reported).
- Pregnancy: FDA Category C. Animal studies show adverse fetal effects, but adequate human/veterinary studies are lacking. Use only if benefits outweigh risks.
- No Analgesia: Does not provide pain relief or sedation. Ensure adequate depth of anesthesia.
医薬品相互作用
May have a synergistic effect if used concurrently with vecuronium.
May speed the onset of action and enhance the neuromuscular blocking actions of vecuronium; do not give vecuronium until succinylcholine effects have subsided.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
May enhance or prolong the neuromuscular blocking activity.
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
監視
- Level of neuromuscular relaxation (using a peripheral nerve stimulator/train-of-four monitor)
- Heart rate, blood pressure, and ECG
- SpO2 and End-tidal CO2 (capnography)
- Core body temperature
- Neuromuscular function (Peripheral nerve stimulator / Train-of-Four)
- Continuous respiratory monitoring (Capnography/ETCO2, SpO2)
- Heart rate and blood pressure
- Acid-base and electrolyte status (especially potassium)
薬物動態
半減期
吸収
Onset of neuromuscular blockade after IV injection is dose-dependent. In dogs at 0.1 mg/kg IV, full block occurs within 2 minutes. Intratracheal administration (studied in rats) has a slower onset than IV but faster than IM, with a longer duration of action than IV.
分布
Distributes to the neuromuscular junction (motor endplate).
代謝
Partially metabolized in the liver.
消失
Vecuronium and its metabolites are excreted into the bile and urine. Clearance may be delayed in patients with significant renal or hepatic disease.
過剰投与
No cases of vecuronium overdosage have been reported in human or veterinary medicine.
Treatment of Overdose:
- Treat conservatively with mechanical ventilation, oxygen therapy, and IV fluids until the block wears off naturally.
- Pharmacologic Reversal: Blockade can be reversed using an anticholinesterase agent (e.g., edrophonium, physostigmine, or neostigmine) combined with an anticholinergic (atropine or glycopyrrolate) to prevent severe bradycardia and excessive salivation.
- Suggested Reversal Protocol: Neostigmine 0.06 mg/kg IV administered after Atropine 0.02 mg/kg IV.
製品
製剤
- Powder for injection
- Injectable: 10 mg powder for reconstitution
ヒト用医薬品
- Vecuronium Bromide Powder for Injection: 10 mg & 20 mg; in 10 mL & 20 mL vials, with and without diluent (Norcuron, generic)
- Norcuron 10 mg powder for solution for injection
規制ステータス
Available as a human POM (Prescription Only Medicine) used under the cascade.
POM. Used under the prescribing cascade.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
Store commercially available powder at room temperature and protect from light. After reconstitution with sterile water, it is stable for 24 hours at 2-8°C or room temperature (<30°C) in the original container. Contains no preservative; discard unused portions. Do not mix with alkaline solutions (e.g., thiobarbiturates). Physically compatible with D5W, normal saline, D5 in normal saline, and lactated Ringer's.
飼主向け情報
この薬は、病院環境において獣医療の専門家によってのみ使用されます。
- 目的：複雑な手術中、または患者が呼吸を助けるために人工呼吸器を必要とする場合に使用される筋弛緩薬です。
- 安全性：この薬が投与される前に、ペットは完全に眠った状態（全身麻酔）になり、周囲の状況に気づくことはありません。呼吸筋を弛緩させるため、薬が効いている間は獣医療チームが機械を使ってペットの呼吸をサポートします。
- モニタリング：薬の効果が切れ、ペットが自力で快適に呼吸できるようになるまで、訓練を受けた専門家によって継続的にモニタリングされます。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。