Some of the views expressed in the following notes on newly approved products should be regarded as preliminary, as there may have been limited published data at the time of publication, and little experience in Australia of their safety or efficacy. However, the Editorial Executive Committee believes that comments made in good faith at an early stage may still be of value. Before new drugs are prescribed, the Committee believes it is important that more detailed information is obtained from the manufacturer's approved product information, a drug information centre or some other appropriate source.
Esmeron (Organon Teknika)
10 mg/mL in 5 mL and 10 mL ampoules
Indication: muscle relaxation
Rocuronium competes for nicotinic cholinergic receptors at the motor endplate. The effect of this nondepolarising neuromuscular blocker is rapid, with a general paralysis occurring within two minutes of an intravenous injection.
This enables rocuronium to be used for intubation and to facilitate mechanical ventilation. The clinical effect of rocuronium lasts for 30-40 minutes. As the drug is excreted in the bile and urine, the dose should be reduced in patients with significant hepatobiliary or renal disease. The response in children under one year old may be unpredictable. There are no data on children under one month or adults over 80 years old.
Neuromuscular blocking agents can cause the release of histamine, but no significant reactions have yet been reported with rocuronium. Interactions may be anticipated with several drugs including aminoglycosides, diuretics, beta blockers, monoamineoxidase inhibitors, and other anaesthetics such as halothane.
Rocuronium adds to the anaesthetist's choice of drugs for intubation. Rocuronium should not cause the hyperkalaemia, malignant hyperthermia or raised intraocular pressure seen with the depolarising drug suxamethonium. However, suxamethonium has a faster onset, shorter action and a faster spontaneous recovery.
