NMBA Dose, Onset, Duration

Question 1

Succinylcholine (Anectine)

Answer 1

Dose: 1 - 1.5 mg/ kg IV, 4 -5 mg/ kg IM
1.5 - 2 mg/ kg IV (Peds)
2 mg/ kg IV (infants)
Onset: about 1 minute
Duration: 5 - 15 minutes

Question 2

Rocuronium (Zemuron)

Answer 2

Dose: 0.6 mg/ kg (intubation), 1.2 mg/ kg (rapid sequence)
Onset: 1 - 2 minutes
Duration: 30 minutes (intubating dose), up to 70 minutes (RSI dose)

Question 3

Vecuronium (Norcuron)

Answer 3

Dose: 0.1 mg/ kg (intubation), .01mg/ kg (priming dose)
Onset: 2 - 3 minutes (good intubation conditions), 3 - 5 minutes (maximal blockade)
Duration: 25 - 40 minutes (25% recovery), 45 - 60 minutes (95% recovery)

Question 4

Pancuronium (Pavulon)

Answer 4

Dose: 0.1 mg/ kg (initial), 0.02 mg/ kg (maintenance)
Onset: 2 - 5 minutes
Duration: 60 - 100 minutes

Question 5

Mivacurium (Mivacron)

Answer 5

Dose: 0.2 mg/ kg (intubation), 5 - 8 mcg/kg/min (infusion)
Onset: 1 minute
Duration: 10 - 20 minutes

Question 6

Atracurium (Tracrium)

Answer 6

Dose: 0.5 mg/ kg
Onset: 2 - 3 minutes
Duration: 20 - 35 minutes, 60 - 70 minutes (95% recovery)

Question 7

Cisatracurium (Nimbex)

Answer 7

Dose: 0.15 - 0.2 mg/ kg
Onset: 2 - 3 minutes
Duration: 40 - 70 minutes, 20 - 35 minutes (to begin recovery), up to 90 minutes (for 90% return)

Question 8

Neostigmine

Answer 8

Dose: 0.04 - 0.08 mg/ kg (max 5 mg)
Onset: starting at 15 minutes (twitch dependent)
Duration: 1 - 2 hours

• For every 1 mg of Neostigmine - mix with 0.2 mg of glycopyrrolate (sometimes less to prevent severe tachycardia with large doses of glyco)

Question 9

Edrophonium (Enlon)

Answer 9

Dose: 0.5 - 1 mg/ kg
Onset: 1 - 2 minutes
Duration: short

**For every 1 mg of edrophonium - mix with 0.014 mg of Atropine

Question 10

Sugammadex (Bridion)

Answer 10

Dose: Indication depednet
* 2mg/ kg: routine reversal of moderate blokc (T2 appearance)
* 4 mg/ kg: routine reversal of deep block (PTC 1-2)
* 16 mg/ kg: immediate reversal after 1.2 mg/ kg dose of rocuronium
Onset (to achieve TOF ratio 0.9):
* 2 mg/ kg: 2 minutes
* 4 mg/ kg: 3 minutes
* 16 mg/ kg: 1.5 minutes
Duration: Eliminated unchanged via kidneys within 24 hours