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Rocuronium is used for rapid sequence intubation (RSI) when succinylcholine is contraindicated. Doses of rocuronium usually used for RSI (1 mg/kg) allow rapid paralysis (30–60 seconds), but it is prolonged (up to 1 hour). Prior studies have found lower doses (0.6 mg/kg) to be inadequate. In a blinded, randomized, placebo-controlled trial, investigators studied the use of low doses of rocuronium, with or without a small priming dose, in 82 children aged 2 to 7 years who were undergoing elective intubation by anesthesiologists.
Patients were randomized to receive a total of 0.45 mg/kg or 0.60 mg/kg of rocuronium and to receive 10% of the rocuronium dose or saline placebo as an up-front priming dose given 1 minute before the remainder. All subj…