A Novel Anesthetic in Thomsen Myotonia Congenita With Rocuronium and Sugammadex: A Case Report

This report describes the use of continuous rocuronium infusion for paralysis during 2 extensive spinal surgeries in a pediatric patient with Thomsen myotonia congenita. Although paralytics are typically avoided to allow motor-evoked potential monitoring, in this case, paralysis was required to reduce myotonic episodes and related complications. Rocuronium infusion with sugammadex reversal was used successfully, with only one presumed myotonic episode and no serious sequelae. This novel approach highlights the need for anesthesiologists to balance monitoring considerations with patient safety. Our report provides practical guidance to optimize outcomes in similar cases and expand the literature on myotonia management.