Muscle Relaxant Selection for Hemodynamic Stability

Patient Population Considerations

• Benzylisoquinoline muscle relaxants, such as atracurium and cisatracurium, are recommended for patients with renal or hepatic failure due to organ-independent elimination, with cisatracurium being preferred over atracurium because it is more potent and generates less laudanosine metabolite 1

Monitoring and Dosing

• Quantitative neuromuscular monitoring is essential to guide dosing and reversal of muscle relaxants, and should be continued after reversal agent administration to detect potential recurarization 2