Neuromuscular Blocking Agents

Author: Peter Bakes

Educational Pearls:

• The Neuromuscular Junction (NMJ) is a neuronal synapse in skeletal muscle mediated by nicotinic acetylcholine receptors.
• Paralytic agents, commonly used in the ED for intubation, include succinylcholine and rocuronium/vecuronium.
• Succinylcholine is a depolarizing paralytic while rocuronium is a non-depolarizing agent.
• A newly developed reversing agent, sugammadex, can be used to counter the effects of curonium based paralytics. This is especially helpful due to the long duration of action of rocuronium (45 minutes to 1 hour) as compared to succinylcholine (

References: https://www.acep.org/Physician-Resources/Clinical/Thoracic-Respiratory/Rocuronium-vs--Succinylcholine--Which-Is-Best-/