What is Rocuronium? 1
- An intermediate-acting non-depolarizing neuromuscular blocking drug (NDMR) used for rapid induction and intubation.
- Popular for short and intermediate procedures due to its rapid onset and ability to induce neuromuscular block quickly.
Mechanism of Action & Pharmacokinetics 12
- Rocuronium competitively binds to nicotinic acetylcholine receptors at the neuromuscular junction. This prevents ACh from causing muscle contraction
- Onset time is 60-80 seconds for an intubating dose (approximately 0.6 mg/kg).
- Duration of action: 35-45 minutes.
- Dosage is typically based on ideal body weight (IBW) for intubation. 2
Pharmacodynamics 1
Cardiovascular
- Few cardiovascular effects.
Respiratory
- Paralysis impairs airway protection and respiration. Reversal of paralysis must be achieved prior to airway removal.
Neurological
- Adequate depth of anesthesia must be maintained to minimize the risk of awareness during paralysis.
Indications 1
-
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and intubation (opens vocal cords, improves laryngoscopy view). - Maintenance of neuromuscular block during surgery.
- Alternative to succinylcholine in situations where a rapid onset is required without the associated side effects of depolarizing agents.
Dosage 1
- Intubation Dose: 0.6 mg/kg based on ideal body weight (IBW), 1.2 mg/kg for rapid sequence intubation based on ideal body weight (IBW).
- Maintenance Infusion: Dose adjusted based on lean body weight (LBW) to avoid prolonged neuromuscular block, particularly in obese patients. 2
Contraindications 1
- Hypersensitivity to rocuronium or any component of the formulation.
- Use with caution in patients with known neuromuscular disorders.
Complications 1
- Prolonged neuromuscular block, especially in patients with renal impairment.
- Anaphylaxis, though rare, has been reported.