Muscle relaxant used in renal failure –
The unique feature of atracurium is inactivation in plasma by spontaneous nonenzymatic degradation (Hofmann elimination) in addition to that by Alkaline ester hydrolysis.
Consequently, its duration of action is not altered in patients with hepatic/renal insufficiency or hemodynamic compromise → It is the preferred muscle relaxant for such patients as well as for neonates and elderly.
Ketamine
Atracurium
Pancuronium
Fentanyl