Understanding Anesthesiology - The Global Regional Anesthesia ...

ROCURONIUM
Class
Non-depolarizing muscle relaxant (NDMR); shortacting
Mechanism of Action
Competitive inhibitor at the acetylcholine receptors of
the post-synaptic cleft of the neuromuscular junction.
Dose
Intubation: 0.45-.9 mg/kg
Maintenance bolus 0.1-0.2 mg/kg
Not usually administered by infusion
Onset
Dose-dependent:
1-1.5 minutes (0.6 mg/kg)
0.5-1.0 minutes (0.9 mg/kg)
Higher dose is therefore suitable for rapid sequence induction.
Effects
CVS
Very weak vagolytic effect.
MSK
The neuromuscular blockade effects of non-depolarizing
muscle relaxants are potentiated by succinylcholine,
volatile anesthetics, aminoglycosides, lithium, loop diuretics,
lidocaine, magnesium, lithium, ganglionic blockers,
hypothermia, hypokalemia and respiratory acidosis.
Enhanced neuromuscular blockade is seen in patients
with myasthenia gravis or myopathies.
The effects of NDMR are antagonized by cholinesterase
inhibitors. Increased resistance to NDMRs is seen in patients
on theophylline, burn patients and those with paresis
or paralysis.
Misc.
Muscle relaxants are the most common cause of anaphylactoid
reactions under general anesthesia.
Duration
Dose-dependent:
31 minutes (0.6 mg/kg)
60 minutes (0.9 mg/kg)
Elimination
Hepato-biliary (70%); renal (10%)
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