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Rocuronium (Injection)

Relaxes muscles during surgery or other medical procedures.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Rocuronium injection is used with general anesthesia medicines for rapid sequence intubation and routine tracheal intubation. This medicine is also used to help relax the muscles during surgery or mechanical ventilation. This medicine is to be given only by your doctor or other trained health professional… Read more
Brand names include
PremierPro Rx rocuronium bromide, Zemuron
Drug classes About this
Musculoskeletal Agent

What works? Research summarized

Evidence reviews

Meta-analysis of the differences in the time to onset of action between rocuronium and vecuronium

This review found that the onset of action of rocuronium is at least 20 seconds and up to 70 seconds faster than vecuronium. Although the review was generally well conducted, limitations of the literature search and a failure to report adequate details of the included studies mean that the reliability of these conclusions is uncertain.

Impact of the intubation model on the efficacy of rocuronium during rapid sequence intubation: systematic review of randomized trials

This well-conducted review assessed the impact of the intubation model on the efficacy of rocuronium compared with succinylcholine for rapid sequence intubation (RSI). The authors concluded that, where a true RSI model was used, rocuronium could be as effective as succinylcholine, but this was also dose- and induction-agent dependent. The conclusions are likely to be reliable.

Succinylcholine or rocuronium: a meta-analysis of the effects on intubation conditions

The review concluded that succinylcholine was associated with an increased frequency of excellent endotracheal intubation conditions and a decreased frequency of unacceptable endotracheal intubation conditions in comparison with rocuronium in adults. In view of some methodological limitations of the review and potential issues with generalisability and confounding in the included studies, the authors' conclusions should be interpreted with caution.

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Summaries for consumers

Comparison of two muscle relaxants, rocuronium and succinylcholine, to facilitate rapid sequence induction intubation

In emergency situations some patients need a general anaesthetic with an endotracheal tube (tube to help them breathe). It is important to have fast acting medications to allow physicians to complete this procedure quickly and safely. Currently, the muscle relaxant medication most often used to accomplish this is succinylcholine. Succinylcholine is fast acting and lasts for only a few minutes which is very desirable in this setting. However, some patients cannot use this medication as it can cause serious salt imbalances or reactions, so an equally effective medication without these side effects is desired. This meta‐analysis compared one possible alternative, rocuronium, for the quality of intubation conditions (the ease with which physicians can quickly and safely pass the endotracheal tube). In this review, we have combined the results of 37 studies, with a total of 2690 patients, which compared the effects of succinylcholine versus rocuronium on intubation conditions. We have found that rocuronium is less effective than succinylcholine for creating excellent intubation conditions. Rocuronium should therefore only be used as an alternative to succinylcholine when it is known that succinylcholine should not be used.

Sugammadex, a new medication for selective reversal of muscle weakness after surgery

Muscle relaxation is required to facilitate some surgical procedures. If it is not completely reversed after surgery, the muscle relaxation effects might lead to remaining muscle weakness, breathing problems, lung infection and delayed recovery. Neostigmine and other medications from the same drug family are currently used to restore muscle function after surgery. These medications, however, are not effective in all situations and may cause complications as well. Complications include changes in the heart and lung function, and nausea and vomiting after surgery. Sugammadex is a new medication that is used after surgery in order to reverse the effects of muscle relaxation medications. In this review article we have included 18 trials on the efficacy and safety of sugammadex. The trials included a total of 1321 patients. Sugammadex was shown to be more effective than placebo (no medication) or neostigmine in reversing muscle relaxation caused by neuromuscular blockade during surgery and is relatively safe. Serious complications occurred in less than 1% of the patients who received sugammadex. The results of this review article (specially the safety results) need to be confirmed by future trials on larger patient populations.

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