Skeletal muscle relaxant of choice in liver and renal disease is?
High-Yield Explanation
ANSWER: (B) AtracuriumREF: Lee synopsis of anesthesia 12th e p. 215Repeat in December 2011Muscle relaxantRoute of eliminationPancuronium , Vecuronium , RapacuroniumLiverVecuronium , RocuroniumBiliarySch , MivacuriumPseudocholinesteraseGallamine , MetocurineRenalAtracurium, cis-atracuriumHoffman's elimination Obtain AMPLE' history and examine patinet |PrepareEquipment. Personnelmedications|Monitor and preoxygenateECG and oulse oximeter|Premedicate* Gve atropine- Indicateo to' all children <5 years of age- Indicated for all patients wen suociny choline is used* If succinycholine to be used; consider defasciculation (0.01 mg/kg of Vecuronium or Pancuromjmj* Give ildocaine for head injury or increased ICP|Secsle (choose ore option eased onccnd tion of patent)|||||Nomotensive* Midazolam or* E:oir cate or* Thiopental or* PropofolHypotensive/hypovolemicHead injury or status epilepticusStatus asthmaticus* Ketamine or* MidazolamMidSevereNormotensiveHypotensive* Etonidale or* Etorrcateor* T-opentalor* Etomdate or* Ketamine or* Ketam-e cr* Propofol cr* Lew-dose thiopental* Midazolam* None* Tetomidate |||||| | Apply criood pressure when patient is unconscious|Paralyze .(choose one)* Rocurcnium* Vecuronium* Suoclnylcholine|* intubate Irachea* Evaluate and confirm tube placement (eg. exhaled CO2)* Secure tracheal tube* Observe and monitor* Administer additonal sedaton and paralytics PRN 'AMPLE r stony allergy medications, past history, last meal and events leading to need for intubation.