rocuronium + neostigmine

Rocuronium + neostigmine refers to a specific pharmacological regimen used as the 'moderate neuromuscular blockade' arm in a clinical trial (NCT03210376) conducted at the M.D. Anderson Cancer Center. This regimen was evaluated in elderly patients undergoing robotic prostatectomy for prostate cancer. Rocuronium is a non-depolarizing neuromuscular blocking agent (NMBA) that acts as a competitive antagonist at nicotinic acetylcholine receptors at the neuromuscular junction, inducing muscle relaxation. In this specific trial arm, rocuronium was dosed to maintain a moderate level of blockade (defined by 1-2 train-of-four counts). Neostigmine, an acetylcholinesterase inhibitor, was subsequently administered at the end of the procedure to reverse the blockade by increasing the concentration of acetylcholine at the synapse. The study compared this standard-of-care approach to deep neuromuscular blockade reversed with sugammadex, specifically investigating the incidence of postoperative shoulder pain, a common complication of robotic abdominal surgery.

Other names

moderate neuromuscular blockade-M.D. Anderson Cancer Center-prostate cancerModerate Neuromuscular BlockadeModerate NMB