General anesthesia with muscle relaxant in a patient with spinal muscular atrophy type III: A case report

Abstract

Background: Spinal muscular atrophy (SMA) is a group of inherited diseases due to degeneration of anterior horn cells of the spinal cord; it causes hypotonia, muscle weakness and atrophy. Anesthetic management is often difficult in patients because of the muscle changes. Case Report: A 15-years-old girl (42 kg) with SMA type III due to a large abscess of low back was candidate for surgery. The patient was anesthetized and intubated and then, were subjected to surgery in the prone position. Atracurium was used to facilitate intubation (5 mg/kg). After surgery, the patient was awake and moved to the recovery room. In the recovery room, she went under respiratory distress; the patient was reversed again and transferred to the intensive care unit (ICU) after full recovery. Conclusion: Patients with SMA are prone to delayed muscle relaxation in postoperative recovery room. So, as possible, one should avoid the use of muscle relaxants in this patients, and if necessary, lower doses must be used.