Which nondepolarizing neuromuscular blocker has the shortest duration of action?

Cisatracurium is the nondepolarizing neuromuscular blocker with the shortest duration of action among the options provided. This is primarily due to its unique metabolic pathway. Cisatracurium undergoes a process known as spontaneous degradation, which makes it less dependent on liver function or renal clearance for its elimination. This allows it to be broken down faster than other neuromuscular blockers, leading to a shorter duration of action.

In contrast, Pancuronium has a longer duration because it is primarily eliminated by renal excretion, which can prolong the drug's effects in patients with impaired kidney function. Rocuronium offers a rapid onset but has a longer duration compared to Cisatracurium due to its metabolism through both hepatic and renal pathways. Vecuronium also has a moderate duration of action, being metabolized by the liver and eliminated via the kidneys. Thus, Cisatracurium stands out for its relatively quick onset and shorter duration, making it suitable for procedures requiring brief muscle relaxation.