Rocuronium bromide: clinical application of single-dose pharmacokinetic models to continuous infusion

Excerpt

Rocuronium has become the neuromuscular blocking agent of first choice immediately after its launch in Japan. Although having fast onset as well as intermediate duration of action and a lack of prolonged effects, which make it suitable for continuous infusion [1, 2], intermittent administration has been standardly used, probably because of its large inter-individual variations of action after bolus and continuous administration [1]. Its neuromuscular blocking effect may also be influenced by the amount of muscle and sensitivity to neuromuscular receptors as well as its plasma concentration, which make it difficult to maintain an adequate level of neuromuscular blockade by avoiding excessive dosing. Therefore, the establishment of an adequate continuous administration regimen is required. …