Anesthetic Considerations in Congenital Myasthenic Syndrome: A Case Report

Congenital myasthenic syndrome poses unique anesthetic challenges. Most notably, this rare disease is heterogeneous. Affected individuals' responses to depolarizing and non-depolarizing neuromuscular blocking agents are poorly understood. Additionally, while neuraxial techniques may confer respiratory benefits due to their opioid-sparing profiles, it is unclear to what extent local anesthetics may impair signal transmission at the neuromuscular junction. This case report raises concern for heightened sensitivity to non-depolarizing neuromuscular blocking agents in patients with congenital myasthenic syndrome. Neuraxial analgesia with caudal administration of dilute local anesthetics appears to be safe.