Aminosteroid non-depolarising neuromuscular blocker
Rocuronium bromide
Brand names: Esmeron
Adult dose
Dose: Intubation: 0.6 mg/kg IV (RSI: 1.0–1.2 mg/kg). Maintenance: 0.15 mg/kg boluses or 0.3–0.6 mg/kg/h infusion
Route: IV
Frequency: per induction
Dose adjustments
Renal
Mildly prolonged in renal impairment
Clinical pearls
- RSI alternative to suxamethonium (1.0–1.2 mg/kg) — onset ~60s; reversible by sugammadex
- Most common anaphylaxis trigger in UK anaesthesia (NAP6)
Contraindications
- Hypersensitivity
- Latex allergy (some preparations)
Side effects
- Anaphylaxis
- Prolonged blockade in hepatic dysfunction
- Tachycardia (mild)
- Injection-site reactions
Interactions
- Aminoglycosides
- Magnesium
- Volatile anaesthetics
- Lithium
Monitoring
- Train-of-four
- Cardiovascular
Reference: BNF; AAGBI; NAP6; https://bnf.nice.org.uk/drugs/rocuronium-bromide/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Train-of-Four (TOF) Neuromuscular Monitoring · Neuromuscular Blockade
- MAGGIC Heart Failure Risk Score · Heart Failure
- Long QT Syndrome (Schwartz Score) · Channelopathy / Sudden Cardiac Death
- New Ballard Score — Gestational Age Assessment · Gestational Age
- MGFA Clinical Classification for Myasthenia Gravis · Neuromuscular
- Myasthenia Gravis Activities of Daily Living (MG-ADL) Scale · Neuromuscular
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines