Anaesthetic agent in liver and kidney disease – Anaesthesia MCQ

Which anaesthetic agent is preferred in a patient taken for surgery with bilirubin of 8.6 mg/dl and serum creatinine of 2.1 mg/dl ?

A. Atracurium

B. Vecuronium

C. Pancuronium

D. Rocuronium

Correct answer : A. Atracurium

• Atracurium is the preferred muscle relaxant in a patient with liver dysfunction / renal failure
• It undergoes non specific ester hydrolysis and non enzymatic degradation ( Hoffman degradation )
• It does not depend on the liver / kidney for its deactivation
• Other muscle relaxants that can be given in liver / renal disease are Cisatracurium and Mivacurium