How to Use and the Pit-Falls of Rocuronium in Specific State and Condition—Electrolyte Disorders, Body Temperature and the Interaction, the Direction for Uses in Intensive Care Unit—

Abstract

 Because fast onset and metabolic product do not have pharmacological action, rocuronium is easy to use. However, due to electrolyte disorders or drug interaction, action augmentation or antagonism of neuromuscular blocking agents (NMBAs) may cause unanticipated reactions. Moreover, it is necessary to well understand the pharmacokinetics and pharmacodynamics of rocuronium in hypothermia. When NMBAs are used in the Intensive Care Unit (ICU) compared with in an operating room, it is very likely used for a long time. In addition, we should consider protracted bed rest, drug interactions, underlying diseases, pharmacokinetics and pharmacodynamics. This part comments on a continuous infusion of rocuronium in the ICU, and the pit-falls influencing the fast track of cardiac surgery using rocuronium.