Neuromuscular Blockade Renal Impairment — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGeneral AnaesthesiaNeuromuscular Blockade Renal ImpairmentFRCA Final

A 74-year-old man (ASA III) with CKD (eGFR 22 mL/min) requires elective inguinal hernia repair under GA. Which neuromuscular blocking agent is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Rocuronium

Rocuronium with sugammadex reversal is now the optimal strategy in renal impairment: predictable reversal regardless of renal clearance. Atracurium undergoes Hofmann degradation (organ-independent) and is acceptable, but rocuronium+sugammadex gives more reliable and complete reversal. Pancuronium and vecuronium have significant renal-dependent elimination.

Reference: RCOA – 2023 – Perioperative management of the patient with renal disease