Rocuronium
RSI paralytic (non-depolarizing), Alternative to succinylcholine
Indications
- RSI paralytic (non-depolarizing)
- Alternative to succinylcholine
Adult dosing
- rsi: dose: 1.2; unit: mg/kg; route: IV; weightBased: true; maxDose: 200; maxDoseAbsolute: true; maintenance: dose: 0.6; unit: mg/kg; route: IV; weightBased: true; maxDose: 100; maxDoseAbsolute: true
Pediatric dosing
- rsi: dose: 1.2; unit: mg/kg; route: IV; weightBased: true; maxDose: 200; maxDoseAbsolute: true
Clinical pearls
- Use 1.2 mg/kg (high dose) for RSI — approaches succinylcholine onset speed
- Reversal available with sugammadex (16 mg/kg IV for immediate reversal)
- Preferred over succinylcholine when hyperkalemia is a concern
- Duration longer than succinylcholine — commit to managing the airway
Source and review
- ACEP Clinical Policies, Tintinalli's 9th ed.. Last reviewed: 2024-10-15