維庫溴銨
Vecuronium Bromide
別名: Norcuron · Curlem · Rivecrum · Vecural · Org-NC-45 · Vecuronium bromide · Vecuronii bromidum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
維庫溴銨 (Vecuronium bromide) 是一種中效、合成的氨基類固醇非去極化型神經肌肉阻斷劑。
主要臨床特徵包括：
- 手術輔助：主要作為全身麻醉的輔助藥物，以產生深度的骨骼肌鬆弛。
- 促進醫療處置：非常適合用於協助氣管插管、機械尋氣以及精細的外科手術（例如眼科或骨科手術）。
- 心血管穩定性：與某些其他神經肌肉阻斷劑不同，它對心血管的影響極小，且通常不會引發組織胺釋放。
- 鳥類應用：曾被局部應用於鳥類以誘發散瞳（瞳孔放大），因為鳥類的虹膜含有橫紋肌。
重要臨床提示：維庫溴銨不具備任何鎮痛、鎮靜或失憶特性。它會麻痺所有骨骼肌，包括橫膈膜。在給藥前及給藥期間，病患必須處於完全麻醉、無意識狀態，並接受正壓機械通氣。
作用機轉
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).
安全性與警告
禁忌症
- 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)
不良反應
- 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.
藥物交互作用
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
監測
- 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)
藥物動力學
半衰期
吸收
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.
分佈
Distributes to the neuromuscular junction (motor endplate).
代謝
Partially metabolized in the liver.
排除
Vecuronium and its metabolites are excreted into the bile and urine. Clearance may be delayed in patients with significant renal or hepatic disease.
過量
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.
可用產品
劑型
- Powder for injection
- Injectable: 10 mg powder for reconstitution
人用標示
- 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
各地核准狀態
Available as a human POM (Prescription Only Medicine) used under the cascade.
POM. Used under the prescribing cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
此藥物僅限由獸醫專業人員在醫院環境中使用。
- 用途：這是一種肌肉鬆弛劑，用於複雜手術期間，或當病患需要使用呼吸器協助呼吸時。
- 安全性：在給予此藥物之前，您的寵物將處於完全睡眠（全身麻醉）狀態，對周圍環境毫無知覺。因為它會放鬆呼吸肌肉，獸醫團隊將在藥物作用期間使用機器協助您的寵物呼吸。
- 監測：您的寵物將由受過訓練的專業人員持續監測，直到藥效消退且他們能夠舒適地自行呼吸為止。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。