Vecuronium in Detail

Anesthesia Drugs: About Vecuronium

Vecuronium is a medication given during surgery as part of general anesthesia.

General anesthesia is a two-part process: medication to stop the muscles from moving and medication to make the patient unaware of what is happening during the procedure.

Anesthesiologist prepping a patient for surgery

Andrew Olney / Getty Images

Vecuronium is a neuromuscular blocking agent, a type of muscle relaxant that is commonly referred to as a paralytic agent. It prevents nerve impulses from the brain from signaling the muscles of the body to move, preventing most of the muscles of the body from moving. 

Unlike other muscles in the body, the heart muscle is not significantly affected by vecuronium, so the heart continues to beat after administration of the drug.

Other muscles, like the ones that help the lungs take breaths, are unable to move after vecuronium is given, and the patient must have assistance to breathe during a procedure.

How Vecuronium Is Administered

Vecuronium is given through an IV. It is administered directly into the blood stream, often along with other medications as part of general anesthesia. It takes effect seconds after administration.

Vecuronium is always given with a medication to make the patient unaware of their surroundings to prevent anesthesia awareness, which is when the patient is aware of what is happening during surgery but unable to move.

Why Vecuronium Is Used

Vecuronium is used as part of general anesthesia, preventing the patient from moving during surgery. Movements as small as a twitch could cause a surgical error, so it is important that the patient be absolutely still while the surgeon is operating.

It can also be used to keep a patient still so that a breathing tube can be placed, if there is a need to keep the patient still during that process. It is typically not used long term in the ICU, as other medications such as propofol, etomidate, or Versed are more appropriate.

Vecuronium is not prescribed or dispensed for home usage and is only appropriate for use in an acute care setting such as an operating room, intensive care unit, or other areas where close monitoring is available and the patient can be on a ventilator.

Vecuronium and General Anesthesia

The use of vecuronium requires that the patient be intubated and placed on a ventilator. This is because the diaphragm, the group of muscles that allow us to breathe, is paralyzed.

With muscles paralyzed, the lungs are unable to take in a breath. Minimal effort is required to exhale, but inhalation requires multiple muscles or a ventilator to do the work of those muscles. 

During surgery, the patient has a breathing tube in the airway that allows them to be connected to the ventilator. Once connected, the ventilator does the work of the diaphragm during surgery, helping the lungs expand as they fill with air before allowing air to be exhaled.

This process is then repeated with each breath given by the ventilator. 

Vecuronium Side Effects

Vecuronium works on most major muscles of the body, including the intestines. After surgery it may take hours or even a few days for the digestive tract to “wake up” from surgery—slowed gastric motility is a potential side effect of vecuronium.

For this reason, hospital staff may ask questions of a personal nature—including “Have you passed gas or had a bowel movement?”—to determine if the intestines are beginning to function.

Vecuronium may also contribute to fatigue after surgery, a common side effect of general anesthesia that is given both with and without vecuronium. 

Vecuronium should only be used when necessary in patients who have liver and/or kidney disease, and those patients may find that it takes longer for the medication to wear off than is typical after surgery.

Before Surgery

If you are having surgery, it is important that both your surgeon and your anesthesia provider are aware of any drugs (prescription or over the counter) that you are taking, and when you last took them.

A Word From Verywell

Vecuronium is a medication that should never be used outside the operating room or other areas where patients can be monitored very closely, such as in an ICU. It is a safe medication when used as directed (on the label) by medical staff who are trained in its use, but it must be accompanied by the respiratory support of a ventilator for as long as the patient needs.

1 Source
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  1. Brown AS. Neuromuscular blocking agents: use and controversy in the hospital setting. U.S. Pharmacist. 2017;42(1):HS16-HS20.

Additional Reading

By Jennifer Whitlock, RN, MSN, FN
Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.