Which neuromuscular blocker is least likely to cause histamine release?

Which neuromuscular blocker is least likely to cause histamine release?

• A. Mivacurium
• B. Pancuronium
• C. Atracurium
• D. Curare

Answer: (B)

Histamine release is a known adverse effect of several nondepolarizing neuromuscular blockers due to mast cell degranulation, which can lead to flushing, hypotension, and bronchospasm. Among the agents listed, the one with the least tendency to provoke histamine release is pancuronium. It is renowned for having minimal histamine-related side effects, though it can cause other cardiovascular effects such as tachycardia from its vagolytic properties. In contrast, d-tubocurarine (curare) is classic for histamine release, and both atracurium and mivacurium can cause histamine release as well, especially with rapid bolus doses.

Histamine release is a known adverse effect of several nondepolarizing neuromuscular blockers due to mast cell degranulation, which can lead to flushing, hypotension, and bronchospasm. Among the agents listed, the one with the least tendency to provoke histamine release is pancuronium. It is renowned for having minimal histamine-related side effects, though it can cause other cardiovascular effects such as tachycardia from its vagolytic properties. In contrast, d-tubocurarine (curare) is classic for histamine release, and both atracurium and mivacurium can cause histamine release as well, especially with rapid bolus doses.