rocuronium extravasation

[nitroglycerine]

Hi, guys. Did anyone have problems with Rocuronium extravasation(tissue damage, prolonged block)?
Thanks.

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[deleted9493]

I would expect the block to be prolonged but not hugely. Peak serum concentration after IM injection is 13 minutes in the pediatric population (http://www.ncbi.nlm.nih.gov/pubmed/9366462). I have never had an accidental SQ extravasation, however. Follow loss of twitches and their return. I wouldn't worry about tissue damage, as IM administration is so well described but would apply a warm compress to maximize local blood flow and uptake of the drug. Reverse with 3+ twitches.

 

[fakin' the funk]

Hi, guys. Did anyone have problems with Rocuronium extravasation(tissue damage, prolonged block)?
Thanks.

Yes. RSI dose went into the neck from a dodgy EJ. No tissue damage. Block lasted 3 hours. Normal renal and hepatic function.

 

[nitroglycerine]

Thanks. It was a 50kg 13 yo patient, 30 mg of Roc on induction after Sufenta 20 and Propofol 200, was still breathing 2 min later durinf intubation, some swelling noted on the arm at IV site. I did not really noticed any loss of twitches at all. Two hours later reversal, although TOF 4/4 and no fade with tetanus 50. Swelling dissapeared by that time. Thanks again.