Which agent is typically administered first allowing for Vecuronium (Norcuron) to maintain paralysis?

Succinylcholine is typically administered first when rapid paralysis is required because it acts quickly to induce muscle relaxation. It is a depolarizing neuromuscular blocker that works by binding to the acetylcholine receptors at the neuromuscular junction, leading to muscle paralysis within seconds. This rapid onset makes it particularly useful in emergency situations, such as intubation.

Once paralysis is achieved with Succinylcholine, Vecuronium can be introduced to maintain the paralysis for a longer duration. Vecuronium is a non-depolarizing neuromuscular blocker that has a slower onset of action compared to Succinylcholine. Therefore, administering Succinylcholine first allows for immediate paralysis, while Vecuronium can provide ongoing muscle control as needed.

In contrast, other agents like Rocuronium, while also a neuromuscular blocker, do not have the same rapid onset as Succinylcholine. Propofol and Etomidate are not neuromuscular blockers at all; they are sedatives often used for induction of anesthesia, but they do not facilitate paralysis. Their roles do not align with the specific requirement for immediate muscle relaxation needed in this scenario.