羅庫溴銨
Rocuronium Bromide
Rocuronium bromide
別名: Zemuron · Esmeron · ORG-9426 · rocuronii · rocuronio · rokuroniowy · rokuronyum · Rocuronium bromide
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
羅庫溴銨（Rocuronium bromide）是一種氨基類固醇類、競爭性、非去極化神經肌肉阻斷劑（NMBA）。它主要作為全身麻醉的輔助藥物，以促進快速氣管插管，並在精細的手術過程中（如眼科、神經外科或胸腔外科手術）提供深度的骨骼肌鬆弛。
主要藥理特徵包括：
- 起效快速至中等：與維庫溴銨（vecuronium）或阿曲庫銨（atracurium）相比，起效更快（比維庫溴銨快2-3倍），幾乎與琥珀膽鹼（succinylcholine）一樣快，但不良反應較少。
- 中等作用時間：作用時間與維庫溴銨和阿曲庫銨相似。
- 心血管穩定性：與較舊的神經肌肉阻斷劑相比，對心血管和組織胺釋放的影響極小。
臨床要點： 像羅庫溴銨這類神經肌肉阻斷劑完全沒有鎮痛、鎮靜或失憶的作用。若給予清醒或麻醉深度不足的病患，將導致病患在完全清醒且能感受到疼痛的情況下全身癱瘓，這是一種極度恐懼的體驗。因此，它只能用於已深度麻醉且能立即提供機械式呼吸輔助的病患。
作用機制
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.
安全性與警告
禁忌症
- 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
不良反應
- 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).
藥物相互作用
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
監測
- 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
藥物動力學
吸收
Rapid to intermediate onset depending on dose when administered IV.
分佈
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.
排除
Primarily hepatic elimination.
過量
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.
可用產品
劑型
- Injection
- Injectable: 10 mg/ml solution
人用標示
- Rocuronium Bromide for Injection 10 mg/mL in 5 mL & 10 mL multi-dose vials
- Esmeron 10 mg/ml solution for injection
各地核准狀態
Human authorized product used under the cascade.
Human authorized product used under the cascade.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
羅庫溴銨是一種專門在醫院全身麻醉期間使用的藥物。
- 用途：它是一種肌肉鬆弛劑，能暫時麻痺骨骼肌。這對於某些精細手術（如眼部、腦部或胸腔手術）至關重要，因為在這些手術中，即使是微小的反射性抽動也可能帶來危險。
- 安全性：在給予此藥物之前，您的寵物將會完全沉睡且沒有知覺（完全麻醉）。因為它會放鬆呼吸肌肉，獸醫團隊會為寵物放置呼吸管，並在藥物作用期間使用人工呼吸器幫助您的寵物呼吸。
- 恢復：藥物的效果會自然消退，或者在手術安全完成後，獸醫可以給予特定的反轉劑（解毒劑）讓肌肉迅速恢復功能。
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