Mivacurium is the only non-depolarizing muscle relaxant that can be reversed by:

• A Sugammadex
• B Neostigmine at half the standard dose
• C Plasma cholinesterase (butyrylcholinesterase) ✓
• D Calcium gluconate infusion

Explanation

Mivacurium is a benzylisoquinolinium non-depolarizing relaxant that is unique in being hydrolyzed by plasma cholinesterase (butyrylcholinesterase), the same enzyme that metabolizes succinylcholine. This gives it a short duration of action (~15–20 minutes) that is spontaneously terminated by plasma hydrolysis. Patients with pseudocholinesterase deficiency will have prolonged blockade with mivacurium, just as with succinylcholine. Sugammadex does not encapsulate benzylisoquinolinium compounds like mivacurium.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.