Anesthetic management of pediatric patient with spinal muscular atrophy

Spinal muscular atrophies are a group of mostly inherited neuromuscular disorders selectively affecting the lower motor neuron resulting in progressive proximal manifestation of muscle weakness. the clinical features ranged from weakness of proximal muscles of the lower limb to dysphagia and respiratory dysfunction. anesthetic management is often difficult in these patients as a result of muscle weakness, respiratory dysfunction, difficult airway management and hypersensitivity to neuromuscular blocking agents. in this case report we describe a child patient with type ii spinal muscular atrophies for left inguinal hernia repair. we decided to use a caudal technique and propofol infusion. we review the available literature and discuss the potential anaesthetic problems in the management of pediatric patients with this degenerative neuromuscular disorder.