Understanding Anesthesiology - The Global Regional Anesthesia ...

Rocuronium
Class
Non-depolarizing muscle relaxant (NDMR); short-acting
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
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.
Duration
Dose-dependent:
31 minutes (0.6 mg/kg)
60 minutes (0.9 mg/kg)
Elimination
Hepato-biliary (70%); renal (10%)
Effect
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.
Related Glossary Terms
Anticholinesterase, Atracurium, Cis-Atracurium, Neuromuscular junction, Non-depolarizing
muscle relaxants, Pancuronium, Peripheral nerve stimulator, Rapid sequence induction, Residual
block
Index
Find Term
Chapter 3 - General Anesthesia
Chapter 3 - General Anesthesia
Chapter 3 - General Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Muscle Relaxants