Anaesthesia for Friedreich's ataxia. Case report and review of the literature.

A patient with Friedreich's ataxia was anaesthetised on two occasions. The neuromuscular blocking agent was atracurium 0.5 mg/kg on the first occasion and tubocurarine 0.5 mg/kg on the second. The effect of each was monitored using the train-of-four twitch technique. Friedreich's ataxia has been reported to cause a marked sensitivity to non-depolarising muscle relaxants and hyperkalaemia, with resulting cardiac dysrhythmias after suxamethonium. This patient did not demonstrate an abnormal response to either relaxant; the operating conditions were satisfactory and recovery was not delayed. These drugs may be safely used in this condition provided that monitoring is adequate.