This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Anaesthesia, Subject name: Pharmacology
A child presents with bladder exstrophy and chronic renal failure. The muscle relaxant of choice to be used during surgery of exstrophy in this child is: 
Select and explain. 
A. Atracurium, B. Mivacurium, C. Pancuronium, D. Rocuronium
A: Atracurium
Answer: A: Atracurium 
Explanation: Ans. (A) Atracurium(Ref: Katzung 11th/e p453, KDT 8th/e p380)Atracurium is eliminated by Hoffman's elimination i.e. it does not require liver or kidney. It is the muscle relaxant of choice in hepatic and renal failure.