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Deep rocuronium reversal — FRCA Primary MCQ

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EasyPharmacologyDeep rocuronium reversalFRCA Primary

At the end of surgery there are no train-of-four twitches after rocuronium, but urgent reversal is needed. Which drug is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Sugammadex

Sugammadex is effective for appropriately dosed reversal of rocuronium-induced deep block. Adenosine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Calcium chloride is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Suxamethonium is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Neostigmine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks