ロクロニウム臭化物
Rocuronium Bromide
Rocuronium bromide
別名: Zemuron · Esmeron · ORG-9426 · rocuronii · rocuronio · rokuroniowy · rokuronyum · Rocuronium bromide
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
ロクロニウム臭化物は、アミノステロイド系の競合的・非脱分極性神経筋遮断薬（NMBA）です。主に全身麻酔の補助薬として使用され、迅速な気管挿管を容易にし、繊細な外科手術（眼科、神経、胸部外科など）中に深い骨格筋弛緩を提供します。
主な薬理学的特徴は以下の通りです：
- 迅速〜中等度の発現：ベクロニウムやアトラクリウムと比較して作用発現が早く（ベクロニウムの2〜3倍）、サクシニルコリンとほぼ同等の速さですが、副作用は少なくなっています。
- 中等度の作用時間：ベクロニウムやアトラクリウムと同様の作用時間です。
- 心血管系の安定性：古いNMBAと比較して、心血管系への影響やヒスタミン放出作用が最小限に抑えられています。
臨床上の重要ポイント： ロクロニウムのような神経筋遮断薬には、鎮痛、鎮静、健忘作用は全くありません。意識がある、または麻酔が不十分な患者に投与すると、完全に意識があり痛みを感じる状態で全身麻痺に陥るという恐ろしい体験を引き起こします。必ず深く麻酔され、人工呼吸器がすぐに利用できる患者にのみ使用しなければなりません。
作用機序
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.
安全性・警告
禁忌
- 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
有害事象
- 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)
注意事項
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).
医薬品相互作用
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
監視
- 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
薬物動態
吸収
Rapid to intermediate onset depending on dose when administered IV.
分布
Specific parameters for veterinary species are not well documented.
代謝
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.
消失
Primarily hepatic elimination.
過剰投与
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.
製品
製剤
- Injection
- Injectable: 10 mg/ml solution
ヒト用医薬品
- Rocuronium Bromide for Injection 10 mg/mL in 5 mL & 10 mL multi-dose vials
- Esmeron 10 mg/ml solution for injection
規制ステータス
Human authorized product used under the cascade.
Human authorized product used under the cascade.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
ロクロニウムは、病院での全身麻酔中に厳密に使用される特殊な薬剤です。
- 目的：骨格筋を一時的に麻痺させる筋弛緩薬です。眼、脳、胸部の手術など、わずかな反射的なピクつきでも危険を伴う繊細な手術において非常に重要です。
- 安全性：この薬が投与される前に、ペットは完全に眠り、意識のない状態（完全な麻酔状態）になります。呼吸用の筋肉も弛緩するため、獣医療チームは呼吸チューブを挿管し、薬が効いている間は人工呼吸器を使用してペットの呼吸をサポートします。
- 回復：薬の効果は自然に切れるか、手術が安全に終了した後に獣医師が特定の拮抗薬（リバーサル剤）を投与して、筋肉の機能を迅速に回復させることができます。
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