In recent years, there’s been growing concern in the medical community regarding the use of general anesthesia on babies facing surgery. Consequently, there’s now a growing trend toward using spinal anesthesia instead.
Employed mainly for shorter procedures (under 90 minutes) that focus on the lower half of the body, from the abdomen on down, the spinal method eliminates pain while leaving infants and toddlers awake and unable to move. It has a number of advantages over general anesthesia and allows parents to bring their young children home sooner by diminishing chances of breathing complications and speeding up recovery time.
The method has been around for about 40 years, but until recently there was little interest among doctors and anesthesiologists in utilizing it, as they were often leery of veering from the traditional method. That attitude began to change after recent studies showed that anesthetic exposure can have debilitating effects on the brains of young animal test subjects as they develop, including problems with learning and memory loss. The study results led to concerns that young children could be vulnerable to the same problems.
A number of studies investigating this question are currently being undertaken worldwide. An interim analysis in the British medical journal the Lancet has found no evidence of harm to cognitive functions by the age of two, but experts are waiting to see the results when the study completes its evaluation in 2017 of kids at the age of 5.
The Society for Pediatric Anesthesia, the American Academy of Pediatrics and the American Society of Anesthesiologists agree that although early results seem encouraging, more questions remain. The interim analysis focused on babies and toddlers who had only a single brief exposure to general anesthesia – under an hour. Until more research is done, it remains an open question whether multiple exposures and/or longer duration exposures might be detrimental. Beyond that, the experts point out that brain function is extremely complex and can’t be properly evaluated in just one test.
Meanwhile, doctors say there are few side effects related to spinal anesthesia. Pediatric surgeon Dr. Kenneth Sartorelli of the University of Vermont Children’s Hospital has reported zero major complications among the approximately 2,500 operations his hospital has performed with the spinal method for surgeries on the lower half of the body. The worst he has seen is headache and the occasional minor infection at the site of the needle penetration.
Pediatric anesthesiologist Emmett Whitaker, a researcher at Nationwide Children’s Hospital in Columbus, Ohio, believes it’s a good idea to at least offer spinal anesthesia as a choice to parents when the procedure is applicable. That way, if it turns out that general anesthesia does indeed cause difficulties for kids down the road, “We won’t look back and say we wish we had offered an alternative.”
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