Which nondepolarizing drug is known to release histamine and is often avoided when histamine release is undesirable?

Which nondepolarizing drug is known to release histamine and is often avoided when histamine release is undesirable?

• A. d-Tubocurarine
• B. Rocuronium
• C. Cisatracurium
• D. Pipecuronium

Answer: (A)

Histamine release is a known adverse effect of some nondepolarizing neuromuscular blockers. d-Tubocurarine is the classic agent that causes a notable histamine surge from mast cells, leading to vasodilation and hypotension and potentially bronchospasm or bronchoconstriction. Because of these effects, it is avoided when a patient’s airway or blood pressure is a concern or when histamine-related symptoms would be particularly undesirable. Other nondepolarizing agents used today—rocuronium, cisatracurium, and pipecuronium—have far less histamine release and are preferred in patients at risk for histamine-mediated complications. Cisatracurium, in particular, is known for minimal histamine effects, with rocuronium and pipecuronium causing little to no clinically significant histamine release in most cases.

Histamine release is a known adverse effect of some nondepolarizing neuromuscular blockers. d-Tubocurarine is the classic agent that causes a notable histamine surge from mast cells, leading to vasodilation and hypotension and potentially bronchospasm or bronchoconstriction. Because of these effects, it is avoided when a patient’s airway or blood pressure is a concern or when histamine-related symptoms would be particularly undesirable.

Other nondepolarizing agents used today—rocuronium, cisatracurium, and pipecuronium—have far less histamine release and are preferred in patients at risk for histamine-mediated complications. Cisatracurium, in particular, is known for minimal histamine effects, with rocuronium and pipecuronium causing little to no clinically significant histamine release in most cases.