Which neuromuscular blocking agent does not cause fasciculations?

The correct response indicates that both vecuronium and rocuronium do not lead to fasciculations.

Fasciculations are involuntary muscle contractions that often occur with the administration of depolarizing neuromuscular blockers, such as succinylcholine. This agent initially activates the muscle fibers by depolarizing the neuromuscular junction, leading to a widespread contraction before paralysis sets in.

In contrast, vecuronium and rocuronium are non-depolarizing neuromuscular blockers. These agents work by competitively inhibiting the action of acetylcholine at the neuromuscular junction without causing initial depolarization of the muscle fibers. Therefore, their mechanism of action does not involve the rapid muscle contractions associated with fasciculations.

Understanding the distinction in action between depolarizing and non-depolarizing neuromuscular blockers is key in critical care, especially when considering the implications for patient comfort and the management of neuromuscular blockade in various clinical scenarios.