Rocuronium

Aliases: Zemuron  

Indications: Rapid Sequence Induction         

Contraindications: Patients with anticipated difficult airways who can be managed by basic maneuvers / BVM / CPAP with adequate oxygenation and ventilation.  

Concentrations: 

Injection: 10mg/mL

Dosing

Adult:

Indication Dose Route Note 
Rapid Sequence Induction 1.5 mg/kgIV PushMay wait at least 60 seconds for full effect

Pediatric:

Indication Dose Route Note 
Rapid Sequence Induction 1.5 mg/kgIV PushMay wait at least 60 seconds for full effect
Use Handtevy or Approved Pediatric Reference Guide for Amount to Administer

Precautions:  Prior administration of succinylcholine may enhance the neuromuscular blocking effect of rocuronium and its duration of action.    

Adverse/Side Effects: Hypersensitivity reactions are possible Use caution in patients with known significant hepatic disease, pulmonary hypertension, valvular heart disease, causes respiratory paralysis. Supportive airway control must always be always continuous and under direct observation.  

Class: Non-depolarizing neuromuscular blocking agent 

Mechanism of Action: Rocuronium bromide acts by competing with acetylcholine for cholinergic receptors at the motor end plate. Rapid to intermediate onset of action, depending on dose, with an intermediate duration of action. It has no analgesic properties, and the patient may be conscious and without the means to communicate. Patients should be a sedative (fentanyl/ketamine) as Rocuronium has no effect on level of consciousness. First muscles affected include eyes, face, neck; followed by limbs, abdomen, chest; diaphragm affected last. Recovery usually occurs in the reverse order and may take longer than 60 minutes.    

Onset of ActionPeak EffectDuration of Action 
< 2 minutes 1-3 minutes20-60 minutes