To exclude a prolonged duration of action of succinylcholine, we suggest using clinical assessment (return of spontaneous breathing and movements) and monitoring to evaluate recovery after its administration. （Conditional recommendation based on very low level of evidence）

Succinylcholine should not be used in children with myasthenic disorders. If NMB is necessary, rocuroniumor or vecuronium is prefered as they can be reversed with sugammadex. If rocuronium or vecuronium are not available or contraindicated (e.g. allergy), atracurium, cisatracurium or mivacurium can be used. Neostigmine should not be used in children with myasthenic disorders, as it can contribute to postoperative cholinergic or myasthenic crises and is contraindicated in some forms of congenital myasthenia. Regardless of the NMBA used, the dose should be titrated according to the level of NMB, as evaluated with quantitative neuromuscular monitoring. （Conditional recommendation based on very low level of evidence）

Succinylcholine should be avoided in patients with Duchenne and Becker Muscular Dystrophy due to the risk of severe rhabdomyolysis and fatal hyperkalaemic cardiac arrest. Instead, a nondepolarising NMBA, such as rocuronium or cisatracurium, should be preferred, including for rapid sequence induction and intubation. （Conditional recommendation based on low level evidence）

Due to the delayed onset and prolonged recovery of NMB, doses of all nondepolarising NMBA (e.g. rocur- onium ≤0.3 mg kg-1) should be titrated in patients with muscular dystrophy to minimise the risk of residual NMB at the end of the intervention. （Conditional recommendation based on very low level evidence）

Due to increased sensitivity and prolonged recovery times, neuromuscular function should be monitored using quantitative techniques. Sugammadex is preferred over neostigmine for reversal to provide a more predictable and safer recovery profile. （Conditional recommendation based on very low level evidence）

We suggest avoiding succinylcholine due to the risk of myotonic contractures. We suggest considering reversal options before NMBA administration, as neostigmine may worsen myotonia. We suggest that sugammadex might be the safest reversal agent. （Conditional recommendation based on very low level of evidence）

Although no hazardous effect of succinylcholine has been reported in children with mitochondrial disorders, we suggest avoiding its use in children with a myopathy associated with a mitochondrial disorder. When using a nondepolarising NMBA in children with a myopathy associated with a mitochondrial disorder, we suggest evaluating the baseline TOF ratio before NMBA administration. We suggest using steroidal nondepolarising NMBA, because of reversal options with sugammadex, thus avoiding the side effects of neostigmine. （Conditional recommendation based on very low level of evidence）

We suggest avoiding the use of succinylcholine in children with a myopathy caused by a glycogen-storage or lipid metabolism disorder because of an increased risk of rhabdomyolysis. When using a nondepolarising NMBA in children with a myopathy caused by a glycogen-storage or lipid metabolism disorder, we suggest evaluating the baseline TOF ratio before NMBA administration. We suggest using steroidal nondepolarising NMBA because of reversal options with sugammadex, thus avoiding the side effects of neostigmine. (Conditional recommendation based on very low level of evidence)

We suggest considering rocuronium or vecuronium due to the reversal option with sugammadex. Neostigmine is more unpredictable pharmacodynamicly compared to sugammadex, which might be of disadvantage in some settings. Regardless of the NMBA used, dose titration according to effect is advised, as evaluated with quantitative neuromuscular monitoring while considering the possible influence of the pathology itself. (Conditional recommendation based on very low level of evidence)

We suggest the use of NMB in children with cerebral palsy, taking into account their altered pharmacodynamic and/or pharmacokinetic status. We suggest quantitative neuromuscular monitoring to minimise complications related to resistance or sensitivity to NMBA. (Conditional recommendation based on very low level of evidence)