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Vecuronium

Overview

Field Detail
Drug class Neuromuscular blocking agent (NMBA)
Stock vial 10 mg powder for injection
Reconstituted conc. 4 mg/mL (add 2.5 mL WFI)
Storage Room temp before; 2–8°C after

Preparation

Before you start

Ensure the vial contains 10 mg of Vecuronium. Check expiry and integrity. Note that this requires 2.5 mL of diluent.

Equipment needed

  • 1 × Vecuronium 10 mg vial
  • Water for injection (WFI) — at least 2.5 mL
  • Normal saline (NS) — for IDT dilutions
  • 5 mL syringe (for reconstitution)
  • 1 mL syringes × 4 (for test doses)
  • 25 G needles

Step 1 — Reconstitution

  1. Reconstitute the 10 mg vial with 2.5 mL WFI.
  2. Dissolve completely to obtain Vecuronium 4 mg/mL (Neat).

Step 2 — Prepare the SPT solution (4 mg/mL — neat)

  1. Draw up 0.5–1 mL of the neat (4 mg/mL) solution into a 1 mL syringe.
  2. Label: "Vecuronium SPT 4 mg/mL".

Step 3 — Prepare IDT dilutions

Prepare in this order, using a fresh syringe for each step.

  1. IDT 0.04 mg/mL (1:100):

    • Draw 0.1 mL of neat (4 mg/mL) into a 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.4 mg/mL — 1:10).
    • Draw 0.1 mL of this 0.4 mg/mL into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.04 mg/mL — 1:100).
    • Label: "Vecuronium IDT 0.04 mg/mL".

  2. IDT 0.004 mg/mL (1:1,000):

    • Draw 0.1 mL of the 0.04 mg/mL syringe into a new 1 mL syringe. Add 0.9 mL NS. Mix. (This is 0.004 mg/mL — 1:1,000).
    • Label: "Vecuronium IDT 0.004 mg/mL".

Skin prick test (SPT)

Reagent Concentration
Test solution Neat (4 mg/mL)
Positive control Histamine 10 mg/mL
Negative control Normal saline

Interpretation: Wheal ≥3 mm vs negative control = positive.

Intradermal test (IDT)

Dilution series

Step Dilution Concentration Preparation
1 1:1,000 0.004 mg/mL 0.1 mL of 0.04 mg/mL + 0.9 mL NS
2 1:100 0.04 mg/mL 0.1 mL of 0.4 mg/mL + 0.9 mL NS

Inject: 0.05 mL intradermal. Read at 15–20 minutes.