Question

Compare and contrast the use of rocuronium and vecuronium during rapid sequence intubation.

What are the indications/contraindications for each?

What is the expected duration of paralysis induced by each?

What is the standard dosing for adult and pediatric patients?

Answer 1

Rocuronium :

Use

• Aminosteroid non derpolarising muscle blocker or a muscle relaxant
• Used for trachea intubation

Indications

• During mechanical ventilation
• Surgery for skeletal muscle relaxation
• Non emergent endotracheal intubation

Contraindications

• Neuromuscular disease (rg., muscular dystrophy )
• Allergic reaction to rocuronium or hypersensitivity
• When using other neuromuscular blocking agents
• Ascities
• Asthma and lung diseases
• Renal failure
• Adrenal insufficiency
• Burns
• Lactating mothers

Expected duration of paralysis

When 0.6mg/kg is administered the duration is 30 minutes and of it is 1.6mg/kg the duration is 67 minutes

Standard dosing

Adult:0.6_1.2mg/kg IV

Paediatric :0.6mg/kg/IV from 3months to 14 years, after 14 years 0.45 to 0.6mg/kg IV

Vecuronium

Use

• Used in endotracheal intubation

Indication

• Adjunct for anaesthesia
• Surgery
• Mechanical ventilation

Contraindications

• Hypersensitivity
• Neuromuscular disease

Duration of action

• It act about 20 to 30 minutes

Standard dosing

Adult:0.08mg/kg IV as injection

Pediatric:infant (0.1mg/kg) as a single dose, 1 to 10 year (0.1mg /kg) every hourly