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: Surgery
[{'content': 'Muscle relaxant not to be used in liver failure: \nSelect and explain. \nA. d- Tubocurare, B. Pancuronium, C. Suxamethonium, D. Decamethonium', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Among muscle relaxants metabolism in liver occurs with pancuronium (10-20%), vecuronium (20%) and biliary excretion occurs with rocuronium (40%). vecuronium (30-40%) and pancuronium (10%). So these agents should be avoided in hepatic diseases. Suxamethonium effect is prolonged in only in severe liver failure due to decreased pseudocholinesterase, so is usually acceptable in mild to moderate cases.', 'role': 'assistant'}]