Train of four fade in a child with stiff baby syndrome

A case is described of a child with stiff baby syndrome who underwent open reduction and femoral shortening of congenital dislocated hip under general anaesthesia. Neuromuscular function was measured electromyographically and demonstrated a great degree of train of four fade (57%) after sevoflurane inhalational induction of anaesthesia. The response to suxamethonium (2 mg. kg(-1)) was normal. The neuromuscular response to volatile anaesthetic agen ts and suxamethonium may be abnormal in these children with stiff baby synd rome and intraoperative neuromuscular monitoring is recommended.