Prolonged paralysis with atracurium use in a patient with Rubinstein-Taybi syndrome

Rubinstein-Taybi syndrome (RTS) is a rare autosomal dominant disorder that occurs due to a microdeletion of chromosome 16p13. The craniofacial abnormalities in these patients may pose a challenge for anaesthetist performing tracheal intubation. However, there are no known reported cases of drug interaction with non-depolarising muscle relaxant in patients with RTS. This young patient with RTS presented with an unexpected prolonged atracurium effect during the course of anaesthesia.

Succinylcholine in Rubinstein-Taybi syndrome

Rubinstein-Taybi syndrome is a congenital anomaly characterized by broad thumbs and first toes facial abnormalities, and mental lietardation. Cardiac anomalies are frequently preset. I predicted that "Succinylcholine ... might cause arrhythmia in patients with Rubinstein-Taybi syndrome". Recently, I once again anesthetized the patient with Rubinstein-Taybi syndrome whom I had earlier described in some detail. The patient, now 14 years old and weighing 22 kg, was admitted to the hospital on the morning of scheduled restorative dentistry.

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