베쿠로늄 브로마이드
Vecuronium Bromide
다른 이름: Norcuron · Curlem · Rivecrum · Vecural · Org-NC-45 · Vecuronium bromide · Vecuronii bromidum
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
베쿠로늄 브로마이드(Vecuronium bromide)는 중간 작용 시간의 합성 아미노스테로이드계 비탈분극성 신경근 차단제입니다.
주요 임상적 특징은 다음과 같습니다:
- 수술 보조：주로 전신 마취의 보조제로 사용되어 깊은 골격근 이완을 유도합니다.
- 시술 용이성：기관 내 삽관, 기계적 환기 및 정밀한 외과 수술(예: 안과 또는 정형외과 수술)을 용이하게 하는 데 이상적입니다.
- 심혈관계 안정성：일부 다른 신경근 차단제와 달리 심혈관계에 미치는 영향이 매우 적으며 일반적으로 히스타민 방출을 유발하지 않습니다.
- 조류에서의 사용：조류의 홍채에는 횡문근이 포함되어 있어 산동(동공 확장)을 유도하기 위해 국소적으로 사용된 바 있습니다.
중요 임상 팁: 베쿠로늄은 진통, 진정 또는 기억 상실 효과가 전혀 없습니다. 횡격막을 포함한 모든 골격근을 마비시킵니다. 투여 전 및 투여 기간 내내 환자는 완전히 마취되어 의식이 없어야 하며 양압 기계 환기를 받아야 합니다.
작용 기전
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).
안전성·주의사항
금기사항
- 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)
부작용
- 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
주의
- 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.
약물 상호작용
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
모니터링
- 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)
약동학
반감기
흡수
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.
분포
Distributes to the neuromuscular junction (motor endplate).
대사
Partially metabolized in the liver.
배설
Vecuronium and its metabolites are excreted into the bile and urine. Clearance may be delayed in patients with significant renal or hepatic disease.
과다투여
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.
제품
제형
- Powder for injection
- Injectable: 10 mg powder for reconstitution
인용의약품
- 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
규제 현황
Available as a human POM (Prescription Only Medicine) used under the cascade.
POM. Used under the prescribing cascade.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
이 약물은 병원 환경에서 수의학 전문가에 의해서만 엄격하게 사용됩니다.
- 목적：복잡한 수술 중이거나 환자가 호흡을 돕기 위해 인공호흡기를 사용해야 할 때 사용되는 근육 이완제입니다.
- 안전성：이 약물이 투여되기 전에 반려동물은 완전히 잠든 상태(전신 마취)가 되며 주변 상황을 전혀 인식하지 못합니다. 호흡 근육을 이완시키기 때문에 약효가 지속되는 동안 수의료진이 기계를 사용하여 반려동물의 호흡을 돕습니다.
- 모니터링：약효가 사라지고 반려동물이 스스로 편안하게 호흡할 수 있을 때까지 훈련된 전문가가 지속적으로 모니터링합니다.
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