What muscle relaxant causes less sedation?

From the Guidelines

Rocuronium is a muscle relaxant that causes less sedation compared to other options like suxamethonium, especially when used at higher doses (greater than 0.9 mg/kg) as it provides similar intubation conditions with potentially fewer side effects 1. When considering muscle relaxants, it's essential to weigh the benefits and risks of each option. Rocuronium, a non-depolarizing muscle relaxant, has been proposed as an alternative to suxamethonium due to its shorter onset time and potentially lower risk of side effects.

• Key factors to consider when choosing a muscle relaxant include the patient's medical history, the specific procedure being performed, and the potential for sedation or other side effects.
• According to a meta-analysis of 50 publications involving 4151 patients, suxamethonium provides excellent intubation conditions more frequently than rocuronium, but with a higher risk of side effects 1.
• However, when comparing suxamethonium 1.0 mg/kg with rocuronium at a dose greater than 0.9 mg/kg, no superiority of suxamethonium was found, suggesting that rocuronium may be a viable alternative with potentially fewer side effects 1.
• Additionally, the use of sugammadex after rocuronium results in a faster and more reliable recovery time than use of suxamethonium, which may also impact the choice of muscle relaxant 1.
• It's crucial to consult with a healthcare provider to determine the best option based on individual patient needs and medical history.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Muscle Relaxants and Sedation

• The studies provided do not directly address the question of which muscle relaxant causes less sedation 2, 3, 4, 5, 6.
• However, it can be inferred that the choice of muscle relaxant may not have a significant impact on sedation levels, as sedation is typically managed through the use of anesthetics and other medications, rather than muscle relaxants.

Comparison of Muscle Relaxants

• Rocuronium and rapacuronium are both non-depolarizing muscle relaxants with rapid onset times 2, 3.
• Rocuronium has a longer duration of action compared to rapacuronium, but may be associated with fewer side effects 2, 3.
• Cisatracurium is a potent non-depolarizing muscle relaxant with a slower onset time compared to rocuronium and rapacuronium 2.
• Atracurium and vecuronium are also non-depolarizing muscle relaxants, with atracurium having a shorter duration of action compared to vecuronium 5, 6.

Clinical Use of Muscle Relaxants

• The choice of muscle relaxant depends on various factors, including the type of surgery, patient characteristics, and anesthetic technique 3, 4, 5, 6.
• Rocuronium and succinylcholine are commonly used for rapid-sequence induction, while cisatracurium and atracurium may be used for longer procedures 2, 3, 4.
• The use of muscle relaxants in patients with renal failure requires careful consideration, as some muscle relaxants may have prolonged durations of action in these patients 5.