UPSC-CMS 2025 — Anesthesiology

Q: The commonly used muscle relaxant with quickest onset of action and spontaneous recovery is :

Suxamethonium. ***Suxamethonium*** - Suxamethonium (succinylcholine) is a **depolarizing neuromuscular blocker** with the most rapid onset of action (30-60 seconds) due to its unique mechanism. - Its short duration of action and **spontaneous recovery** are due to its rapid hydrolysis by **plasma pseudocholinesterase**, making it ideal for rapid sequence intubation. *Vecuronium* - Vecuronium is an **intermediate-duration non-depolarizing neuromuscular blocker** with an onset of action typically around 3-5 minutes, which is slower than suxamethonium. - It does not undergo spontaneous recovery as rapidly as suxamethonium and often requires administration of a **reversal agent**. *Rocuronium* - Rocuronium is a **non-depolarizing neuromuscular blocker** known for its relatively rapid onset of action (60-90 seconds) among non-depolarizing agents, but it is still slower than suxamethonium. - While it can be reversed quickly with sugammadex, its **spontaneous recovery** is much slower than suxamethonium. *Atracurium* - Atracurium is an **intermediate-duration non-depolarizing neuromuscular blocker** with an onset of action (3-5 minutes) that is slower than suxamethonium. - Its metabolism involves **Hofmann elimination** and ester hydrolysis, providing a degree of organ-independent elimination, but its recovery is not as rapid or spontaneous as suxamethonium. [Practice more Anesthesiology PYQs on OnCourse]

Q: Mallampati test is used for the assessment of :

Airway. ***Airway*** - The **Mallampati test** is a widely used bedside test to assess the **visibility of the soft palate, uvula, tonsillar pillars, and tongue** within the oral cavity. - This assessment helps in predicting the **ease of intubation** and the potential for a difficult airway during anesthesia. *Tongue size* - While the Mallampati test indirectly considers the relative size of the tongue by visualizing how much of the pharynx it obstructs, its primary purpose is not to quantify **tongue size** independently. - The test assesses the **overall oral cavity geometry** for airway management, not just a single anatomical dimension. *Ability to protrude jaw* - The ability to protrude the jaw, or **mandibular protrusion**, is a different airway assessment parameter used to evaluate potential difficulty with intubation. - It is often assessed with the **upper lip bite test** or other maneuvers, not the Mallampati classification. *Breath hold time* - **Breath-hold time** is a measure related to respiratory function and patient cooperation, and it has no direct relevance to the Mallampati test. - The Mallampati test is a **visual assessment** of oral pharyngeal structures at rest or with phonation, not a dynamic respiratory measurement. [Practice more Anesthesiology PYQs on OnCourse]

2 Previous Year Questions with Answers & Explanations

Questions

The commonly used muscle relaxant with quickest onset of action and spontaneous recovery is :

Mallampati test is used for the assessment of :