Rocuronium Kabi

Rocuronium Br

Adjunct to general anaesth to facilitate tracheal intubation during routine sequence induction & to provide skeletal muscle relaxation, during surgery in adult & paed patients (from term neonates to adolescents (0 to <18 yr)). Facilitates tracheal intubation during rapid sequence induction & as an adjunct in ICU (eg, to facilitate intubation), for short term use in adults.

Individualised dosage. Tracheal intubation: Standard intubating dose during routine anaesth 0.6 mg/kg. During rapid sequence induction of anaesth 1 mg/kg. Maintenance 0.15 mg/kg. Long-term inhalational anaesth: Reduce to 0.075-0.1 mg/kg. Continuous infusion Loading dose of 0.6 mg/kg, then start administration by infusion when neuromuscular block starts to recover. IV anaesth infusion rate in adult: 0.3-0.6 mg/kg/hr. Inhalational anaesth infusion rate in adult: 0.3-0.4 mg/kg/hr. Patient undergoing Caesarean section 0.6 mg/kg. Paed patient Same intubation dose w/ adult during routine anaesth & maintenance dose. For continuous infusion, higher infusion rates may be necessary. Geriatric patients, patients w/ hepatic &/or biliary tract disease &/or renal failure Routine anaesth/rapid sequence induction of anaesth 0.6 mg/kg. Maintenance 0.075-0.1 mg/kg. Infusion rate: 0.3-0.4 mg/kg/hr.

Hypersensitivity to rocuronium Br or to Br ion.

Ventilatory support is mandatory until adequate spontaneous respiration is restored. Reports of residual curarization. Anaphylactic reactions. Dose levels >0.9 mg/kg may increase heart rate. Risk of prolonged paralysis &/or skeletal muscle weakness following long-term use in ICU; myopathy after long-term administration in ICU w/ corticosteroid therapy. Patients w/ clinically significant hepatic &/or biliary diseases &/or renal failure; neuromuscular disease or after poliomyelitis; myasthenia gravis or myasthenic syndrome; burns; obese patients. Conditions associated w/ prolonged circulation time eg, CV diseases, old age, oedematous state resulting in an increased vol of distribution; in surgery under hypothermic conditions; hypokalaemia, hypermagnesaemia, hypocalcaemia, hypoproteinaemia, dehydration, acidosis, hypercapnia, cachexia. Patients receiving Mg salts for toxemia of pregnancy. Pregnancy & lactation. Not recommended for facilitating tracheal intubation conditions during rapid sequence induction in paed patients.

Inj site pain/reaction, changes in vital signs, prolonged neuromuscular block.

Increased effect w/ halogenated volatile anaesth; after intubation w/ suxamethonium; w/ high doses of thiopental, methohexital, ketamine, fentanyl, gammahydroxybutyrate, etomidate, propofol; other non-depolarizing neuromuscular blocking agents; prior administration of suxamethonium; long-term concomitant use w/ corticosteroids in the ICU. Altered magnitude &/or duration of effect w/ aminoglycosides, lincosamides (eg, lincomycin & clindamycin), polypeptide antibiotics, acylamino-penicillin antibiotics, tetracyclines, high doses of metronidazole; diuretics, thiamine, MAOIs, quinidine & its isomer quinine, protamine, adrenergic blocking agents; Mg salts, Ca channel blocking agents, lithium salts, local anaesth (lidocaine IV, bupivacaine epidural) & acute administration of phenytoin or β-blocking agents. Reports of recurarization after post-op administration of aminoglycoside, lincosamide, polypeptide & acylamino-penicillin antibiotics, quinidine, quinine & Mg salts. Decreased effect w/ neostigmine, edrophonium, pyridostigmine, aminopyridine derivatives; prior chronic administration of corticosteroids, phenytoin or carbamazepine; noradrenaline, azathioprine (only transient & limited effect), theophylline, Ca chloride, KCl; PIs (gabexate, ulinastatin). Administration of other non-depolarizing neuromuscular blocking agents in combination w/ rocuronium Br may produce attenuation or potentiation of the neuromuscular block. Suxamethonium given after the administration of rocuronium Br may produce potentiation or attenuation of the neuromuscular blocking effect of rocuronium Br. Quicker onset of action of lidocaine. Physical incompatibility when added to soln containing: amphotericin, amoxicillin, azathioprine, cefazolin, cloxacillin, dexamethasone, diazepam, enoximone, erythromycin, famotidine, furosemide, hydrocortisone Na succinate, insulin, intralipid, methohexital, methylprednisolone, prednisolone Na succinate, thiopental, trimethoprim & vancomycin.

Neuromuscular Blocking Agents

M03AC09 - rocuronium bromide ; Belongs to the class of other quaternary ammonium-containing agents used as peripherally-acting muscle relaxants.

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