Summary: Androstanes and androstane derivatives which are substituted in any position with one or more hydroxyl groups.

Top Publications

  1. Lee C, Jahr J, Candiotti K, Warriner B, Zornow M, Naguib M. Reversal of profound neuromuscular block by sugammadex administered three minutes after rocuronium: a comparison with spontaneous recovery from succinylcholine. Anesthesiology. 2009;110:1020-5 pubmed publisher
    ..This study compared time to sugammadex reversal of profound rocuronium-induced neuromuscular block with time to spontaneous recovery from succinylcholine...
  2. Mallon W, Keim S, Shoenberger J, Walls R. Rocuronium vs. succinylcholine in the emergency department: a critical appraisal. J Emerg Med. 2009;37:183-8 pubmed publisher
    ..Non-depolarizing drugs have the advantage of causing less pain due to post-paralysis myalgias...
  3. Wang Z, Bao Y, Lu Z, Yu W. Is neuromuscular relaxation of rocuronium prolonged in patients with obstructive jaundice?. Med Hypotheses. 2011;76:100-1 pubmed publisher
    ..We propose that the effect of rocuronium is prolonged in patients with obstructive jaundice, and a caution should be taken in monitoring postoperative residual neuromuscular blockade. ..
  4. Choi B, Choi S, Shin Y, Lee S, Yoon K, Shin S, et al. Remifentanil prevents withdrawal movements caused by intravenous injection of rocuronium. Yonsei Med J. 2008;49:211-6 pubmed publisher
    ..The pretreatment with 0.5 and 1.0 microg/kg remifentanil of bolus doses prevented the withdrawal movements caused by rocuronium injection, and effectively blunted cardiovascular activation following tracheal intubation. ..
  5. Kocabas S, Yedicocuklu D, Askar F. The neuromuscular effects of 0.6 mg kg(-1) rocuronium in elderly and young adults with or without renal failure. Eur J Anaesthesiol. 2008;25:940-6 pubmed publisher
  6. Marsch S, Steiner L, Bucher E, Pargger H, Schumann M, Aebi T, et al. Succinylcholine versus rocuronium for rapid sequence intubation in intensive care: a prospective, randomized controlled trial. Crit Care. 2011;15:R199 pubmed publisher
    ..Accordingly, the aim of the present study was to compare the incidence of hypoxemia after rocuronium or succinylcholine in critically ill patients requiring an emergent RSI...
  7. Pühringer F, Rex C, Sielenkämper A, Claudius C, Larsen P, Prins M, et al. Reversal of profound, high-dose rocuronium-induced neuromuscular blockade by sugammadex at two different time points: an international, multicenter, randomized, dose-finding, safety assessor-blinded, phase II trial. Anesthesiology. 2008;109:188-97 pubmed publisher
    ..Sugammadex provides a rapid and dose-dependent reversal of profound neuromuscular blockade induced by high-dose rocuronium (1.0 or 1.2 mg/kg) in adult surgical patients. ..
  8. Jones R, Caldwell J, Brull S, Soto R. Reversal of profound rocuronium-induced blockade with sugammadex: a randomized comparison with neostigmine. Anesthesiology. 2008;109:816-24 pubmed publisher
    ..Sugammadex is a novel reversal agent, reversing the effects of rocuronium by encapsulation. This study assessed the efficacy and safety of sugammadex versus neostigmine for reversal of profound rocuronium-induced neuromuscular blockade...
  9. Rex C, Wagner S, Spies C, Scholz J, Rietbergen H, Heeringa M, et al. Reversal of neuromuscular blockade by sugammadex after continuous infusion of rocuronium in patients randomized to sevoflurane or propofol maintenance anesthesia. Anesthesiology. 2009;111:30-5 pubmed publisher
    ..Single-dose sugammadex (4 mg/kg) after continuous rocuronium infusion is equally effective and well tolerated during maintenance anesthesia with sevoflurane or propofol. ..

More Information


  1. Mahajan R, Batra Y, Kumar S. Pain on injection of rocuronium: influence of ketamine pretreatment. Can J Anaesth. 2005;52:111-2 pubmed
  2. Arain S, Kern S, Ficke D, Ebert T. Variability of duration of action of neuromuscular-blocking drugs in elderly patients. Acta Anaesthesiol Scand. 2005;49:312-5 pubmed
    ..05). When used with sevoflurane/N(2)O, there was a two-fold greater variability of duration of neuromuscular blockade in elderly patients receiving rocuronium or vecuronium compared with cisatracurium. ..
  3. Lysakowski C, Suppan L, Czarnetzki C, Tassonyi E, Tramer M. Impact of the intubation model on the efficacy of rocuronium during rapid sequence intubation: systematic review of randomized trials. Acta Anaesthesiol Scand. 2007;51:848-57 pubmed
    ..Propofol-rocuronium is thought to be superior to thiopental-rocuronium for rapid sequence intubation (RSI). The role of the intubation model per se has never been investigated...
  4. Staessen J, Kuznetsova T, Acceto R, Bacchieri A, Brand E, Burnier M, et al. OASIS-HT: design of a pharmacogenomic dose-finding study. Pharmacogenomics. 2005;6:755-75 pubmed
    ..To our knowledge, OASIS-HT is the first Phase II dose-finding study in which a genetic hypothesis is driving primary and secondary end points. ..
  5. Epemolu O, Bom A, Hope F, Mason R. Reversal of neuromuscular blockade and simultaneous increase in plasma rocuronium concentration after the intravenous infusion of the novel reversal agent Org 25969. Anesthesiology. 2003;99:632-7; discussion 6A pubmed
    ..This explains the increase in total plasma concentration of rocuronium (free and bound to Org 25969). ..
  6. Bom A, Bradley M, Cameron K, Clark J, Van Egmond J, Feilden H, et al. A novel concept of reversing neuromuscular block: chemical encapsulation of rocuronium bromide by a cyclodextrin-based synthetic host. Angew Chem Int Ed Engl. 2002;41:266-70 pubmed
  7. Blunk J, Seifert F, Schmelz M, Reeh P, Koppert W. Injection pain of rocuronium and vecuronium is evoked by direct activation of nociceptive nerve endings. Eur J Anaesthesiol. 2003;20:245-53 pubmed
    ..The algogenic effect of aminosteroidal neuromuscular blocking drugs can be attributed to a direct activation of C-nociceptors. ..
  8. Robertson E, Driessen J, Booij L. Pharmacokinetics and pharmacodynamics of rocuronium in patients with and without renal failure. Eur J Anaesthesiol. 2005;22:4-10 pubmed
    ..This increase may be due to a decreased clearance of rocuronium, the disease process causing the renal failure and/or the medication which patients with renal failure need in their treatment. ..
  9. Chiarella A, Jolly D, Huston C, Clanachan A. Comparison of four strategies to reduce the pain associated with intravenous administration of rocuronium. Br J Anaesth. 2003;90:377-9 pubmed
    ..Sodium bicarbonate 8.4% reduced the reporting of pain by 18.4 times (P<0.0001). Sodium bicarbonate 8.4%, when added to rocuronium, markedly reduces the experience of pain during the i.v. administration of a small dose of rocuronium. ..
  10. Maybauer D, Geldner G, Blobner M, Pühringer F, Hofmockel R, Rex C, et al. Incidence and duration of residual paralysis at the end of surgery after multiple administrations of cisatracurium and rocuronium. Anaesthesia. 2007;62:12-7 pubmed
  11. Sparr H, Vermeyen K, Beaufort A, Rietbergen H, Proost J, Saldien V, et al. Early reversal of profound rocuronium-induced neuromuscular blockade by sugammadex in a randomized multicenter study: efficacy, safety, and pharmacokinetics. Anesthesiology. 2007;106:935-43 pubmed
    ..6 mg/kg rocuronium in a dose-dependent manner. Sugammadex enhanced the renal excretion of rocuronium, and its clearance is approximately one third that of rocuronium. ..
  12. Paul M, Kindler C, Fokt R, Dresser M, Dipp N, Yost C. The potency of new muscle relaxants on recombinant muscle-type acetylcholine receptors. Anesth Analg. 2002;94:597-603; table of contents pubmed
  13. Sparr H, Beaufort T, Fuchs Buder T. Newer neuromuscular blocking agents: how do they compare with established agents?. Drugs. 2001;61:919-42 pubmed
    ..In contrast to atracurium, cisatracurium does not undergo hydrolysis by nonspecific plasma esterases. Moreover, about 77% of the drug is cleared by organ-dependent mechanisms. ..
  14. Laurin E, Sakles J, Panacek E, Rantapaa A, Redd J. A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients. Acad Emerg Med. 2000;7:1362-9 pubmed
    ..Although succinylcholine had a faster onset and provided more relaxation, the difference had no clinical significance. Approximately a fourth of ED RSI patients qualified for use of rocuronium using these high-risk criteria. ..
  15. Sluga M, Ummenhofer W, Studer W, Siegemund M, Marsch S. Rocuronium versus succinylcholine for rapid sequence induction of anesthesia and endotracheal intubation: a prospective, randomized trial in emergent cases. Anesth Analg. 2005;101:1356-61 pubmed
    ..We conclude that during rapid sequence induction of anesthesia in emergent cases, succinylcholine allows for a more rapid endotracheal intubation sequence and creates superior intubation conditions compared with rocuronium...
  16. Tuncali B, Karci A, Tuncali B, Mavioglu O, Olguner C, Ayhan S, et al. Dilution of rocuronium to 0.5 mg/mL with 0.9% NaCl eliminates the pain during intravenous injection in awake patients. Anesth Analg. 2004;99:740-3, table of contents pubmed
    ..06 mg/kg to 0.5 mg/mL with 0.9% NaCl is a simple and cost-effective strategy for preventing pain during IV rocuronium injection. ..
  17. Han T, Kim H, Bae J, Kim K, Martyn J. Neuromuscular pharmacodynamics of rocuronium in patients with major burns. Anesth Analg. 2004;99:386-92, table of contents pubmed
    ..Resistance to the neuromuscular effects of rocuronium was partially overcome by increasing the dose. A dose up to 1.2 mg/kg provides good tracheal intubating conditions after major burns. ..
  18. Turan A, Memis D, Karamanlioglu B, Sut N, Pamukcu Z. The prevention of pain from injection of rocuronium by magnesium sulphate, lignocaine, sodium bicarbonate and alfentanil. Anaesth Intensive Care. 2003;31:277-81 pubmed
    ..Of these drugs, magnesium sulphate, lignocaine and sodium bicarbonate were the most effective while alfentanil was the least effective. ..
  19. Lui J, Huang S, Yang C, Hsu J, Lui P. Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration. Chang Gung Med J. 2002;25:617-20 pubmed
    ..We describe a case of gastric regurgitation with pulmonary aspiration following generalized spontaneous movements associated with rocuronium injection in a girl who received pediatric emergent surgery. ..
  20. Memis D, Turan A, Karamanlioglu B, Sut N, Pamukcu Z. The prevention of pain from injection of rocuronium by ondansetron, lidocaine, tramadol, and fentanyl. Anesth Analg. 2002;94:1517-20, table of contents pubmed
    ..Ondansetron, lidocaine, tramadol, and fentanyl were effective in preventing and decreasing the level of rocuronium injection pain. Among these drugs, lidocaine was the most effective, and fentanyl was the least effective. ..
  21. Mencke T, Beerhalter U, Fuchs Buder T. Spontaneous movements, local reactions and pain on injection of rocuronium. A comparison between female and male patients. Acta Anaesthesiol Scand. 2001;45:1002-5 pubmed
    ..The incidence and the degree of withdrawal reactions in response to the injection of rocuronium were significantly higher in women than in men. This was not associated with adverse clinical consequences for the patient's outcome. ..
  22. Whalley D, Maurer W, Knapik A, Estafanous F. Comparison of neuromuscular effects, efficacy and safety of rocuronium and atracurium in ambulatory anaesthesia. Can J Anaesth. 1998;45:954-9 pubmed
    ..Once begun, the spontaneous recovery profile of rocuronium is slightly slower than that of atracurium. ..
  23. Ahmad N, Choy C, Aris E, Balan S. Preventing the withdrawal response associated with rocuronium injection: a comparison of fentanyl with lidocaine. Anesth Analg. 2005;100:987-90 pubmed
    ..05). In conclusion, both fentanyl and lidocaine are effective clinical treatments to alleviate the withdrawal response associated with rocuronium injection, with fentanyl being more effective. ..
  24. Sorgenfrei I, Norrild K, Larsen P, Stensballe J, Ostergaard D, Prins M, et al. Reversal of rocuronium-induced neuromuscular block by the selective relaxant binding agent sugammadex: a dose-finding and safety study. Anesthesiology. 2006;104:667-74 pubmed
    ..At doses of 2.0 mg/kg or greater, sugammadex safely reversed 0.6 mg/kg rocuronium-induced neuromuscular block in a dose-dependent manner. Sugammadex enhanced renal excretion of rocuronium and was excreted unchanged by the kidneys. ..
  25. England A, Panikkar K, Redai I, Haxby E, Gopinath S, Feldman S. Is rocuronium an exception to the relation between onset and offset? A comparison with pipecuronium. Eur J Anaesthesiol. 1996;13:385-8 pubmed
    ..This suggests that onset, recovery, or both onset and recovery, from rocuronium blockade occur in a different manner to that of other non-depolarizing agents. ..
  26. Groudine S, Soto R, Lien C, Drover D, Roberts K. A randomized, dose-finding, phase II study of the selective relaxant binding drug, Sugammadex, capable of safely reversing profound rocuronium-induced neuromuscular block. Anesth Analg. 2007;104:555-62 pubmed
    ..The mean time to recovery decreased with increasing doses. Profound rocuronium-induced neuromuscular block can be reversed successfully with sugammadex at doses >/=2 mg/kg. ..
  27. Reddy M, Chen F, Ng H. Effect of ondansetron pretreatment on pain after rocuronium and propofol injection: a randomised, double-blind controlled comparison with lidocaine. Anaesthesia. 2001;56:902-5 pubmed
    ..0001) compared with placebo, and significantly better with lidocaine than with ondansetron (p = 0.02). We conclude that ondansetron is effective in relieving the pain of rocuronium but is not as effective as lidocaine. ..
  28. Woloszczuk Gebicka B, Lapczynski T, Wierzejski W. The influence of halothane, isoflurane and sevoflurane on rocuronium infusion in children. Acta Anaesthesiol Scand. 2001;45:73-7 pubmed
    ..Significant patient-to-patient variability of infusion rate makes monitoring of neuromuscular transmission necessary. ..
  29. Atherton D, Hunter J. Clinical pharmacokinetics of the newer neuromuscular blocking drugs. Clin Pharmacokinet. 1999;36:169-89 pubmed
    ..Cisatracurium has an intermediate clearance (0.3 L/h/kg) and short elimination half-life (26 minutes). Hepatic and renal disease have little effect on its pharmacokinetics. ..
  30. Wulf H, Ledowski T, Linstedt U, Proppe D, Sitzlack D. Neuromuscular blocking effects of rocuronium during desflurane, isoflurane, and sevoflurane anaesthesia. Can J Anaesth. 1998;45:526-32 pubmed
    ..Interaction of rocuronium and volatile anaesthetics resulted in augmentation of the intensity of neuromuscular block but did not result in significant effects on duration of or recovery from the block. ..
  31. Suy K, Morias K, Cammu G, Hans P, van Duijnhoven W, Heeringa M, et al. Effective reversal of moderate rocuronium- or vecuronium-induced neuromuscular block with sugammadex, a selective relaxant binding agent. Anesthesiology. 2007;106:283-8 pubmed
    ..A dose-response relation was observed with sugammadex for reversal of both rocuronium- and vecuronium-induced neuromuscular block. ..
  32. Ferrari P, Ferrandi M, Valentini G, Bianchi G. Rostafuroxin: an ouabain antagonist that corrects renal and vascular Na+-K+- ATPase alterations in ouabain and adducin-dependent hypertension. Am J Physiol Regul Integr Comp Physiol. 2006;290:R529-35 pubmed
  33. Narimatsu E, Niiya T, Kawamata M, Namiki A. Sepsis stage dependently and differentially attenuates the effects of nondepolarizing neuromuscular blockers on the rat diaphragm in vitro. Anesth Analg. 2005;100:823-9, table of contents pubmed
    ..The results indicate that sepsis induces hyposensitivities to nondepolarizing neuromuscular blockers, the degree of which depends on the stage of sepsis and on the kind of neuromuscular blocker...
  34. Debaene B, Plaud B, Dilly M, Donati F. Residual paralysis in the PACU after a single intubating dose of nondepolarizing muscle relaxant with an intermediate duration of action. Anesthesiology. 2003;98:1042-8 pubmed
    ..Quantitative measurement of neuromuscular transmission is the only recommended method to diagnose residual block. ..
  35. Ferrari P, Ferrandi M, Tripodi G, Torielli L, Padoani G, Minotti E, et al. PST 2238: A new antihypertensive compound that modulates Na,K-ATPase in genetic hypertension. J Pharmacol Exp Ther. 1999;288:1074-83 pubmed
    ..Because adducin gene mutations have been associated with human essential hypertension, it is suggested that PST 2238 may display greater antihypertensive activity in those patients carrying such a genetic alteration. ..
  36. Kelsaka E, Karakaya D, Zengin E. Use of sugammadex in a patient with amyotrophic lateral sclerosis. Med Princ Pract. 2013;22:304-6 pubmed publisher
    ..v. was given, the patient was extubated 120 s later. This case highlights that rocuronium and sugammadex can be used safely in patients with amyotrophic lateral sclerosis undergoing surgery with general anesthesia. ..
  37. Raft J, Leclercq M, Longrois D, Meistelman C. [Fast recovery of haemodynamic and ventilatory functions after sugammadex bolus following rocuronium-induced anaphylactic shock refractory to conventional treatment]. Ann Fr Anesth Reanim. 2012;31:158-61 pubmed publisher
  38. Feltman D, Weiss M, Nicoski P, Sinacore J. Rocuronium for nonemergent intubation of term and preterm infants. J Perinatol. 2011;31:38-43 pubmed publisher
    ..9±43.4), and duration from 1 to 60 min (16.3±13.5). Rocuronium facilitated successful intubation and provided clinical paralysis quickly in most infants. ..
  39. Joyce C, Greenwald B, Han P. Bilateral Dilated Nonreactive Pupils in a Neonate After Surgery. A A Case Rep. 2016;6:286-7 pubmed publisher
    ..We report a case of bilateral fixed and dilated pupils in a 1-week-old low-birth-weight neonate, which we contend was secondary to centrally mediated neuromuscular blockade. ..
  40. Beny K, Piriou V, Dussart C, Henaine R, Aulagner G, Armoiry X. [Impact of sugammadex on neuromuscular blocking agents use: a multicentric, pharmaco-epidemiologic study in French university hospitals and military hospitals]. Ann Fr Anesth Reanim. 2013;32:838-43 pubmed publisher
    ..The commercialization of sugammadex seems to have induced a discrete increase of steroidal NMBA but non-steroidal NMBA remain the leading agent in France. A long-term follow-up is deserved. ..
  41. Yamamoto M, Murao K, Kimoto M, Inoue S, Kanouda T, Nakamura K, et al. [Use of sugammadex in a patient with narrow angle glaucoma]. Masui. 2011;60:1185-8 pubmed
    ..Intraocular pressure stayed below 20 mmHg during the intervention. We could achieve full reversal of neuromuscular blockade and suppress increase in intraocular pressure with use of sugammadex. ..
  42. Menéndez Ozcoidi L, Ortiz Gómez J, Olaguibel Ribero J, Salvador Bravo M. Allergy to low dose sugammadex. Anaesthesia. 2011;66:217-9 pubmed publisher
    ..Other diagnostic tests supported a diagnosis of allergic reaction to sugammadex. ..
  43. Hoshi H, Kadoi Y, Kamiyama J, Nishida A, Saito H, Taguchi M, et al. Use of rocuronium-sugammadex, an alternative to succinylcholine, as a muscle relaxant during electroconvulsive therapy. J Anesth. 2011;25:286-90 pubmed publisher
    ..In conclusion, this study demonstrates the potential benefit of use of rocuronium-sugammadex as an alternative to succinylcholine for muscle relaxation during ECT. ..
  44. Choi S, Park S, Lee J, Lee S, Chung C. Effect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery. J Anesth. 2009;23:489-93 pubmed publisher
    ..05). Propofol or remifentanil anesthesia was associated with a higher incidence of OCR during pediatric strabismus surgery than sevoflurane and desflurane anesthesia, when either ketamine or midazolam was used as an induction agent. ..
  45. Lee C, Katz R. Clinical implications of new neuromuscular concepts and agents: so long, neostigmine! So long, sux!. J Crit Care. 2009;24:43-9 pubmed publisher
    ..The present article assesses the clinical implications of such therapeutic regimen, and provides an educated guess on how the clinical neuromuscular practice might change, if and when sugammadex becomes clinically available. ..
  46. Hashimoto Y, Gotanda Y, Ito T, Ushijima K. [Recovery from rocuronium by sugammadex does not affect motor evoked potentials]. Masui. 2011;60:968-71 pubmed
    ..Taking these findings into consideration, it is likely that rocuronium might not affect the MEP when reversed by sugammadex, and should be safe for smooth tracheal intubation in patients who need MEP monitoring. ..
  47. Tang Z, Liu S, Cheng Z, Li Q, Wang Y, Guo Q. [Narcotrend for monitoring the anesthetic depth during endotracheal intubation in sevoflurane anesthesia]. Nan Fang Yi Ke Da Xue Xue Bao. 2010;30:1654-7, 1662 pubmed
    ..NCT and BIS can not serve such a purpose in combined anesthesia with sevoflurane and rocuronium. ..
  48. Cordero Escobar I. [Rocuronium vs vecuronium for neuromuscular block during transsternal thymectomy in the patient with myasthenia gravis]. Rev Esp Anestesiol Reanim. 2011;58:578-82 pubmed
    ..With this blocking agent we were able to circumvent respiratory depression, with its immediate consequences, and thus meet the main clinical criterion when anesthetizing patients with myasthenia gravis. ..
  49. Choi S, Ahn H, Yang M, Kim C, Sim W, Kim J, et al. Comparison of desaturation and resaturation response times between transmission and reflectance pulse oximeters. Acta Anaesthesiol Scand. 2010;54:212-7 pubmed publisher
  50. Pickard A, Lobo C, Stoddart P. The effect of rocuronium and sugammadex on neuromuscular blockade in a child with congenital myotonic dystrophy type 1. Paediatr Anaesth. 2013;23:871-3 pubmed publisher
    ..Sugammadex reversed the block rapidly. The anesthetic management of children with MD1 has been well described but not the acceleromyographic monitored use of rocuronium and its subsequent reversal with the new cyclodextrin sugammadex. ..
  51. Choi S, Yi J, Rha Y. Rocuronium anaphylaxis in a 3-year-old girl with no previous exposure to neuromuscular blocking agents. Asian Pac J Allergy Immunol. 2013;31:163-6 pubmed publisher
    ..This case cautions and informs practitioners that an IgE-mediated anaphylactic reaction with rocuronium is possible even in young children with no previous exposure to NMBAs. ..
  52. Takazawa T, Horiuchi T, Yoshida N, Yokohama A, Saito S. Flow cytometric investigation of sugammadex-induced anaphylaxis. Br J Anaesth. 2015;114:858-9 pubmed publisher
  53. Kopman A. Sugammadex-rocuronium dosing. Anesth Analg. 2007;105:883-4; author reply 884 pubmed