[Verse 1]
Succinylcholine walks in fast, depolarizing every end plate
Fasciculations ripple through, the potassium can't wait
Burns and denervation, myopathies on the floor
Prolonged immobility — don't open that door
Pseudocholinesterase deficient? Paralysis extends
Malignant hyperthermia lurks around the bends
Raises intraocular, raises intracranial too
Bradycardia in children — black box warning, hear it through
[Chorus]
TOF, TOF, train-of-four tells you where you stand
Quantitative monitoring — never guess, demand
Neostigmine needs glycopyrrolate beside
Sugammadex encapsulates, reversal deep and wide
Rocuronium, vecuronium, cis-atracurium's Hofmann fade
Pancuronium, atracurium — know the choices that were made
Phase II block, residual harm, potentiation all around
Magnesium, volatiles, aminoglycosides compound
[Verse 2]
Non-depolarizing agents, competitive at the receptor
Rocuronium hits in sixty seconds — rapid intubator
Vecuronium runs on liver, intermediate in stay
Pancuronium vagolytic, slow and long to fade away
Cisatracurium degrades through Hofmann elimination
No organ dependence — kidneys, liver — no hesitation
Atracurium releases histamine, watch the pressure dip
Choose your agent for the patient, don't let safety slip
[Chorus]
TOF, TOF, train-of-four tells you where you stand
Quantitative monitoring — never guess, demand
Neostigmine needs glycopyrrolate beside
Sugammadex encapsulates, reversal deep and wide
Rocuronium, vecuronium, cis-atracurium's Hofmann fade
Pancuronium, atracurium — know the choices that were made
Phase II block, residual harm, potentiation all around
Magnesium, volatiles, aminoglycosides compound
[Bridge]
Neostigmine hits a ceiling — acetylcholinesterase inhibition
Time it right or muscarinic chaos joins the mission
Sugammadex doses deeper for profound rocuronium block
Sixteen milligrams per kilogram to reverse the total lock
Hormonal contraceptives — interaction, seven-day gap
Anaphylaxis rare but real — keep epinephrine on the map
Renal failure? Accumulation — clearance starts to crawl
Acidosis, hypothermia, volatiles potentiate them all
[Verse 3]
Residual block post-extubation — hypoxia on the ward
TOF ratio under ninety percent — an outcome you can't afford
Quantitative monitoring isn't optional, it's standard of care
Subjective tactile feeling of four twitches leaves you bare
Phase two block from succinylcholine — repeated dosing leads
Infusion without monitoring plants complications like seeds
Know your depth before reversing — sugammadex by block level
Shallow, moderate, profound — dose accordingly, be level