Rocuronium and vecuronium have a longer duration of action in neonates due to:
a) Larger volume of distribution
b) Smaller volume of distribution
c) There is no difference
d) Increased clearance
e) Decreased plasma esterase degradation
Answer a. Both rocuronium and vecuronium have a longer duration of action in neonates due to a large volume of distribution and mildly decreased clearance. Rocuronium undergoes primarily hepatic elimination with some renal elimination and vecuronium undergoes hepatic metabolism and both renal and hepatic elimination.