Prolonged residual paralysis after a single intubating dose of rocuronium

• Published in: British Journal of Anaesthesia Vol. 99; no. 4; pp. 514 - 517
• Main Authors: Claudius, C., Karacan, H., Viby-Mogensen, J.
• Format: Report
• Language: English
• Published: Oxford University Press 01-10-2007
• Subjects: monitoring; neuromuscular block; neuromuscular function; recovery; rocuronium
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aem213

It is often argued that neuromuscular monitoring is unnecessary when only one dose of an intermediate-acting neuromuscular blocking agent is given. This case report documents that it may take more than 3.5 h before it is possible to antagonize a block caused by a normal dose of rocuronium (0.6 mg kg−1). Possible causes of the extremely prolonged duration of action are discussed, as is the importance of quantitative neuromuscular monitoring.