A 63-Year-Old Man Hospitalized for Chronic Obstructive Pulmonary Disease Exacerbation

A 63-year-old man hospitalized for chronic obstructive pulmonary disease exacerbation develops hypercapnic respiratory failure.  He is transferred to the intensive care unit, where he undergoes intubation after premedication with muscle relaxant X and an appropriate sedative.  The patient is then started on mechanical ventilation; however, he remains apneic longer than expected.  Anesthesiology is consulted, and the patient's neuromuscular blockade is assessed by electrically stimulating a peripheral nerve 4 times in quick succession and observing the muscular response.  The procedure is repeated 30 minutes later and the results are shown below. Muscle relaxant X is most likely to be which of the following medications?

A) Dantrolene
B) Midazolam
C) Pancuronium
D) Succinylcholine
E) Tubocurarine

Correct Answer:

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