Previous case studies reported delayed emergence from general anesthesia in a child with citrullinemia[6] and spinal anesthesia without significant neurologic events despite recurrent hyperammonemic episodes in adult patients with CTLN2.[7] However, case reports of anesthetic management in patients with citrin deficiency at different clinical stages are still sparse. Here, SLC25A13 is linked to hyperinsulinemic hypoglycemia, familial, 4.