Shortest acting NDMR:
## **Core Concept**
The question tests knowledge of non-depolarizing muscle relaxants (NDMRs), specifically their duration of action. NDMRs are a class of neuromuscular blocking agents used in anesthesia to facilitate endotracheal intubation and provide muscle relaxation during surgery.
## **Why the Correct Answer is Right**
Sugammadex is a selective relaxant binding agent (SRBA) used for reversal of NDMRs but is not an NDMR itself; however, among the options provided for NDMRs, **Cisatracurium** and other agents have varying durations of action. The shortest acting NDMR among commonly known agents is **Mivacurium**. Mivacurium has a rapid onset and short duration of action (approximately 15-20 minutes), making it useful for procedures requiring brief muscle relaxation.
## **Why Each Wrong Option is Incorrect**
- **Option A:** While specific details are not provided due to the format, if we consider common NDMRs like Succinylcholine (which is technically a depolarizing agent and not listed but often confused), it has a very short duration but is not a NDMR. Other agents like Vecuronium or Rocuronium have longer durations compared to Mivacurium.
- **Option B:** This option would be incorrect based on the pharmacological profile of the agent listed. If it were a longer-acting agent like Pancuronium, it would not be the shortest acting.
- **Option D:** Similarly, if this option represents a longer-acting NDMR like Doxacuronium, it would not be the correct answer.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that Mivacurium is metabolized by plasma cholinesterase, which can lead to prolonged paralysis in patients with atypical or deficient enzyme activity. This is a critical consideration in clinical practice.
## **Correct Answer: C. Mivacurium.**