Anesthetic management of a patient with type III spinal muscular atrophy and multinodular goiter undergoing elective thyroidectomy: A case report

Abstract Background Anesthesia management in Spinal Muscular Atrophy (SMA) patients is challenging due to muscle weakness, respiratory complications, and increased sensitivity to muscle relaxants. Additionally, benign multinodular goiter can cause airway obstruction due to tracheal deviation, compression, or extension behind the sternum. Case presentation: Here, we report a case of a spinal muscular atrophy type III patient with a huge multinodular goiter who was a candidate for total thyroidectomy. We performed awake nasal fiberoptic intubation with the spray-as-you-go technique without using any muscle relaxant. Conclusion Managing anesthesia in neuromuscular patients is challenging. Awake fiberoptic intubation presents a promising technique to avoid muscle relaxants and minimize respiratory complications.