Rocuronium

Provider Level

RN/Paramedic

Class

Nondepolarizing neuromuscular blocking agent

Mechanism of Action

Competitively binds to nicotinic cholinergic receptors at the motor end-plate, antagonizing acetylcholine and causing skeletal muscle paralysis.

Indications

Induction of paralysis for rapid sequence intubation (RSI) and maintenance of paralysis for mechanically ventilated patients.

Contraindications

Known hypersensitivity to rocuronium or bromides. Inability to secure or manage the airway.

Routes

IV, IO

Onset / Duration

Onset: 1 to 2 minutes. Duration: 30 to 60 minutes.

Adverse Effects

Apnea, bronchospasm, tachycardia, transient blood pressure changes (hypertension or hypotension), arrhythmias.

Precautions & Interactions

Does not provide sedation or analgesia. Duration may be prolonged in patients with hepatic or renal failure, or neuromuscular diseases.

Special Considerations

Ensure appropriate sedation and analgesia are given concurrently. Must have backup airway equipment ready. Sugammadex is the specific reversal agent if needed.