Bromuro de rocuronio
Rocuronium Bromide
Rocuronium bromide
También conocido como: Zemuron · Esmeron · ORG-9426 · rocuronii · rocuronio · rokuroniowy · rokuronyum · Rocuronium bromide
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a neuromuscular blocker | 0.5 mg/kg bolus and then a CRI was started immediately at 0.2 mg/kg/hour | IV | Bolus followed by CRI | — | 🌎 NA |
| Neuromuscular blockade during anaesthesia | 0.4 mg/kg i.v. followed, when required, by a maintenance dose of 0.16 mg/kg i.v. prn or continuous rate infusion of 0.2 mg/kg/h | IV | prn or CRI | As needed during surgery | 🌍 EU |
| Centralize the globe for ophthalmic surgery | 0.05-0.1 mg/kg i.v. | IV | Single dose or prn | As needed | 🌍 EU |
- As a neuromuscular blocker: Authors concluded it was effective and easily applicable, but further work is required on infusion titration.
- Neuromuscular blockade during anaesthesia: Monitoring with a nerve stimulator is recommended.
- Centralize the globe for ophthalmic surgery: Considerably lower doses are required for this indication.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a neuromuscular blocker | 0.6 mg/kg IV | IV | Single dose | — | 🌎 NA |
| Neuromuscular blockade / Endotracheal intubation | 0.3-0.6 mg/kg i.v. | IV | Single dose | Approx 20 min at 0.6 mg/kg | 🌍 EU |
- As a neuromuscular blocker: Rapid onset, short duration of action, and does not cause significant changes in heart rate.
- Neuromuscular blockade / Endotracheal intubation: 0.6 mg/kg has a rapid onset and short duration of action (20 min). Requires prompt successful intubation and ventilation.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| As a neuromuscular blocker | 0.6 mg/kg IV | IV | Single dose | — | 🌎 NA |
- As a neuromuscular blocker: Provided predictable blockade without hemodynamic changes, but large variation between individuals; monitoring of neuromuscular block is essential.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El bromuro de rocuronio es un agente aminosteroideo competitivo, bloqueante neuromuscular no despolarizante (BNM). Se utiliza principalmente como coadyuvante de la anestesia general para facilitar la intubación endotraqueal rápida y proporcionar una relajación profunda del músculo esquelético durante procedimientos quirúrgicos delicados (p. ej., cirugías oftálmicas, neurológicas o torácicas).
Las características farmacológicas clave incluyen:
- Inicio de acción rápido a intermedio: Inicio de acción más rápido en comparación con vecuronio o atracurio (2-3 veces más rápido que el vecuronio), lo que lo hace casi tan rápido como la succinilcolina pero con menos efectos adversos.
- Duración de acción intermedia: Duración similar a la del vecuronio y el atracurio.
- Estabilidad cardiovascular: Presenta efectos cardiovasculares y de liberación de histamina mínimos en comparación con los BNM más antiguos.
Perla clínica: Los agentes bloqueantes neuromusculares como el rocuronio no poseen absolutamente ninguna propiedad analgésica, sedante o amnésica. La administración a un paciente consciente o anestesiado de forma inadecuada resultará en la experiencia aterradora de una parálisis completa mientras está totalmente despierto y capaz de sentir dolor. Debe utilizarse únicamente en pacientes que estén profundamente anestesiados y donde la ventilación mecánica esté disponible de inmediato.
Mecanismo de acción
Rocuronium acts by competitively antagonizing acetylcholine (ACh) at the neuromuscular junction.
- Mechanism: It binds to nicotinic cholinergic receptors at the motor end plate of skeletal muscle.
- Pathway: Rocuronium occupies the receptor site → prevents ACh from binding → inhibits depolarization of the muscle cell membrane → results in flaccid paralysis.
- Reversal: Because the blockade is competitive, it can be antagonized by increasing the concentration of ACh in the synaptic cleft. This is achieved using acetylcholinesterase inhibitors (e.g., neostigmine, edrophonium). Alternatively, rocuronium can be directly encapsulated and inactivated in the plasma by the selective relaxant binding agent sugammadex.
Seguridad y advertencias
Contraindicaciones
- Hypersensitivity to rocuronium or other neuromuscular blocking agents
- Patients who are not adequately anesthetized or sedated
- Settings lacking immediate access to intubation, mechanical ventilation, and oxygen therapy
- Conscious or inadequately anaesthetized animals
- Lack of positive pressure ventilation facilities
Efectos adversos
- Changes in heart rate (mild, transient tachycardia)
- Changes in blood pressure (hypotension or hypertension)
- Severe anaphylaxis (reported in humans)
- Histaminoid reactions (rare)
- Severe burning pain at the injection site (if administered before deep anesthesia is achieved)
- Increased heart rate
- Mild hypertension (at high doses)
Precauciones
Rocuronium must only be used by trained personnel in settings where the patient can be fully monitored and where endotracheal intubation, mechanical ventilation, oxygen therapy, and reversal agents are immediately available.
It should only be administered to patients that are adequately anesthetized or sedated. Because the drug can cause severe burning pain upon injection, it is recommended to administer it only after a deep stage of anesthesia has been achieved. Use with caution in patients with hepatic or renal impairment, as elimination may be delayed (some sources prefer atracurium in these patients).
Interacciones farmacológicas
May have a synergistic effect if used concurrently with rocuronium.
May speed the onset of action and enhance the neuromuscular blocking actions of rocuronium; do not give rocuronium until succinylcholine effects have subsided.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
May enhance or prolong the neuromuscular blocking activity of rocuronium.
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Prolonged neuromuscular blockade
Monitorización
- Degree of neuromuscular blockade (using a peripheral nerve stimulator/Train-of-Four monitor)
- Heart rate and rhythm
- Oxygenation (SpO2) and ventilation (End-tidal CO2)
- Depth of anesthesia
- Neuromuscular blockade depth (using a peripheral nerve stimulator)
- Heart rate and blood pressure
- Spontaneous respiratory effort during recovery
Farmacocinética
Absorción
Rapid to intermediate onset depending on dose when administered IV.
Distribución
Specific parameters for veterinary species are not well documented.
Metabolismo
Eliminated primarily by the liver in dogs and cats. The principle metabolite, 17-desacetyl-rocuronium, has approximately 1/20th the neuromuscular-blocking potency of the parent drug in cats.
Eliminación
Primarily hepatic elimination.
Sobredosis
Overdosage with neuromuscular blocking agents results in prolonged neuromuscular blockade (extended paralysis).
- Primary Treatment: Maintenance of a patent airway, continuous mechanical ventilation, oxygenation, and adequate sedation/anesthesia until full recovery of muscle function is assured.
- Reversal: Only after spontaneous evidence of recovery is observed should administration of an anticholinesterase drug (e.g., neostigmine) combined with an anticholinergic agent (e.g., atropine or glycopyrrolate to prevent severe bradycardia) be considered.
- Specific Antidote: Rocuronium's effects can be rapidly and specifically reversed by sugammadex, a cyclodextrin binding agent that encapsulates the drug in the plasma.
Productos disponibles
Formulaciones
- Injection
- Injectable: 10 mg/ml solution
Etiquetado para humanos
- Rocuronium Bromide for Injection 10 mg/mL in 5 mL & 10 mL multi-dose vials
- Esmeron 10 mg/ml solution for injection
Estado regulador
Human authorized product used under the cascade.
Human authorized product used under the cascade.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store at 2°-8°C (36°-46°F). Do not freeze. When removed from refrigeration to room temperature storage conditions (25°C; 77°F), use within 60 days. Use opened vials of rocuronium within 30 days. Infusion solutions should be used within 24 hours of mixing. Unused portions of infusion solutions should be discarded.
Información para el cliente
El rocuronio es un medicamento especializado que se utiliza estrictamente en un entorno hospitalario durante la anestesia general.
- Propósito: Es un relajante muscular que paraliza temporalmente los músculos esqueléticos. Esto es crucial para ciertas cirugías delicadas (como cirugías de ojos, cerebro o tórax) donde incluso un pequeño espasmo reflejo podría ser peligroso.
- Seguridad: Su mascota estará completamente dormida e inconsciente (anestesiada por completo) antes de que se administre este fármaco. Debido a que relaja los músculos respiratorios, el equipo veterinario colocará un tubo endotraqueal y utilizará un ventilador mecánico para respirar por su mascota mientras el fármaco esté haciendo efecto.
- Recuperación: Los efectos del fármaco desaparecen de forma natural, o el veterinario puede administrar un agente de reversión específico para reactivar los músculos rápidamente una vez que la cirugía se haya completado de forma segura.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.