Question about Vecuronium

  1. 0
    Ok-let me preface this by saying I am a first year SRNA. . . I have a question regarding potency of vecuronium. When doing a long case and you have used more than one bottle of vec has anyone had issues with what seemed to be different levels of potency between bottles?? I have had at least one case (maybe two) where pt would remain flat/or 1 twitch with same amount over same period of time-got a new bottle and just didn't seem to be working same way (no changes to any other settings-gas, etc. etc.) Mixed a new bottle and voila-was back in business. Just wondering if anyone else has experienced this- I looked online for any other discussions regarding this and couldn't find anything-maybe I am crazy, but the CRNA I was with suggested she had seen that before. Anyone????
  2. Get our hottest nursing topics delivered to your inbox.

  3. 3,132 Visits
    Find Similar Topics
  4. 11 Comments so far...

  5. 0
    I remember this being a big problem when Norcuron went off patent, and we started using generic vecuronium. My department's collective opinion was that there was a real difference in predictability between the brand and the generic.

    Don't know if this is still the feeling there, that facility has changed formulary to all rocuronium now.

    And I don't know if this has ever been formally documented anywhere.

    loisane crna
  6. 0
    Quote from loisane
    I remember this being a big problem when Norcuron went off patent, and we started using generic vecuronium. My department's collective opinion was that there was a real difference in predictability between the brand and the generic.

    Don't know if this is still the feeling there, that facility has changed formulary to all rocuronium now.

    And I don't know if this has ever been formally documented anywhere.

    loisane crna
    I think you're correct, there does seem to be more variability with the generic vec.

    If it wasn't significantly more expensive, we'd probably use even more roc than we currently do. Anything longer than 3 hrs or so, we tend to lean towards vec because of the cost savings. A few of our anesthetists are using cis-atracurium, but I've never been thrilled with it personally.
  7. 0
    gonnabe ... not on the subject but are you at UNC Charlotte?
  8. 0
    Quote from gonnabe
    Ok-let me preface this by saying I am a first year SRNA. . . I have a question regarding potency of vecuronium. When doing a long case and you have used more than one bottle of vec has anyone had issues with what seemed to be different levels of potency between bottles?? I have had at least one case (maybe two) where pt would remain flat/or 1 twitch with same amount over same period of time-got a new bottle and just didn't seem to be working same way (no changes to any other settings-gas, etc. etc.) Mixed a new bottle and voila-was back in business. Just wondering if anyone else has experienced this- I looked online for any other discussions regarding this and couldn't find anything-maybe I am crazy, but the CRNA I was with suggested she had seen that before. Anyone????
    Yup...I've noticed that too...never gave it much thought until you brought it up here. Thought maybe I was going crazy! :chuckle Then again, maybe I am! LOL
  9. 0
    Found this by accident in practice. Directions for Vec are to mix with sterile water, I use whatever in the drawer. If you use NS, doesn't last as long.
    FYI
  10. 0
    Thanks Quiigley,
    I have to think that may have been the case with at least my last experience. We often pre-mix and have ready to go in drawer-so sometimes may have been drawn up by somebody else and they used NS-I often use myself figuring it really didn't make much difference. Guess it does-thanks for the enlightenment!!!!! Maybe I'll be able to predict my timing a little better
  11. 0
    Quote from Qwiigley
    Found this by accident in practice. Directions for Vec are to mix with sterile water, I use whatever in the drawer. If you use NS, doesn't last as long.
    FYI
    Well, that couldn't explain my experiences...I ALWAYS mix with sterile water.
  12. 0
    I thought mixing with sterile water (vs NS) just has an effect on the solubility, making the vec powder mix quickly- not the half life of the drug- because don't you inject into a line that generally has NS infusing through it??
  13. 0
    JWK,
    Why don't you like cis-atracurium? I just started using it and really like it. Am I just getting lucky or have you had a negative experience with it?


Top