This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Anaesthesia
[{'content': 'Which is the muscle relaxant of choice in renal failure? \nSelect and explain. \nA. Rocuronium, B. Vecuronium, C. Rapacuronium, D. Atracurium', 'role': 'user'}, {'content': "Answer: D \nExplanation: Atracurium and cis-atracurium are inactivated by Hoffman's elimination. It is the spontaneous molecular re- arrangement of these drugs leading to their inactivation without the requirement of liver or kidney. Therefore they are the muscle relaxants of choice for renal and hepatic failure patients. Also know Elimination of muscle relaxants: Renal Hepatic Both None Doxacurium Rapacuronium Pipecuronium Atracurium Tubocurarine Vecuronium Cis-atracurium Pancuronium Rocuronium Mivacurium Succinyl choline Ref: Katzung 9th/pg. 432; KDT 6th/pg. 345.", 'role': 'assistant'}]