Neuromuscular Blocker

Rocuronium

Aminosteroid non-depolarizing NMBA · Zemuron

Mechanism: Competitive ACh receptor antagonist at neuromuscular junction.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Patient weight

Computed weight

70.0 kg · 154.3 lb

Intubation

42 mg

= 4.20 mL (10 mg/mL)

RSI: 1.2 mg/kg.

RSI dose

84 mg

= 8.40 mL (10 mg/mL)

Weight is saved on this device for the next calculator you open.

Full dose calculator

Onset

60–90 sec (RSI dose) / 2–3 min (standard)

Duration

30–60 min (longer with high dose)

Metabolism

Primarily hepatic (biliary excretion).

Dosing

Adult

Intubation: 0.6 mg/kg (RSI 1.0–1.2 mg/kg). Maintenance: 0.1–0.2 mg/kg.

Pediatric

0.6–1.2 mg/kg IV.

Indications

Tracheal intubation
Intraoperative paralysis
RSI alternative

Contraindications

Hypersensitivity

Side Effects

Mild tachycardia (vagolytic)
Anaphylaxis (most common NMBA trigger)

Clinical Pearls

1RSI alternative to sux when sux is contraindicated — pair with sugammadex availability.

2Sugammadex 16 mg/kg reverses even profound block.

References & Further Reading

1
Textbook
Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.
2
Textbook
Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.
3
Textbook
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, Holt NF. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017.
4
Textbook
Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.