General anesthesia is typically what babies receive when they need surgery, but a New Hampshire hospital is finding spinal anesthesia is a far better alternative and uses it routinely for certain complex procedures.
Although commonly used, there is debate about how safe general anesthesia is for babies. The Food and Drug Administration in 2016 issued a warning about the potential harms to brain development when using general anesthesia on children younger than 3. The agency requires warning labels on general anesthetic and sedation drugs while also stating more research is needed.
But even excluding debates about whether or not general anesthesia impedes brain development, physicians at 296-bed Elliot Hospital in Manchester, N.H., prefer to use spinal anesthesia because of its benefits to the patient.
Spinal anesthesia is applied by inserting a 25-gauge needle into the patient’s back with numbing medication. The patient is awake throughout the numbing process, which takes seconds. When the effects set in after a few minutes, the baby usually falls asleep naturally during surgery. Otherwise, nurses sing the baby lullabies to keep them calm.
“They tolerate this practice so beautifully—they have major surgery while taking a nap,” said Dr. Elizabeth Soukup, a pediatric surgeon at Elliot.
In comparison, general anesthesia puts babies into a medically induced coma where their natural breathing stops and a ventilator takes over. This process takes much longer, and there are more risks associated with it, said Dr. Charles Eastwood, a pediatric anesthesiologist at Elliot Hospital.
With general anesthesia “if you put a child to sleep and you aren’t able to put a breathing tube in them, you are in a bad situation. If you make an error in dosage, you are in a dangerous situation,” he said.
Soukup said it was a gradual process for the team at Elliot to adapt spinal anesthesia for laparoscopic surgery.