Spinal anesthesia brings peace of mind to parents of babies undergoing urologic surgery
For babies who need certain short surgical procedures, the board-certified pediatric urologists at UI Stead Family Children’s Hospital have an option that some parents are welcoming enthusiastically: spinal anesthesia.
Shorter hospital stays for certain procedures
Spinal anesthesia is an approach that few hospitals can offer. Instead of using general anesthesia for a brief procedure such as a circumcision, the anesthesiologist administers medication through the spine that numbs the baby from the waist down while also blocking pain. The baby remains alert and can stay awake through the procedure.
UI Stead Family Children’s Hospital is one of a handful of leading U.S. medical centers making this technique available so that parents who are trying to limit their child’s exposure to general anesthesia have a safe and effective alternative.
The approach has a number of advantages, including a shorter amount of time spent in the hospital, says UI pediatric urologist Gina M. Lockwood, MD.
“Unlike with general anesthesia, parents don’t have to wait for their baby to wake up from spinal anesthesia,” Lockwood says. “The baby is alert and can be fed in the recovery room, and the family can go home almost right away.”
Spinal anesthesia also doesn’t require a mask or a breathing tube, elements of pediatric surgery that can make many parents uncomfortable.
“For parents who may be even more concerned about the anesthesia than the surgery itself, this can be a really nice option,” Lockwood says.
An old approach finds new popularity
UI pediatric anesthesiologist Stephen Robert Hays, MD, says the use of spinal anesthesia for children dates back more than a century, but the approach has gained increasing interest in recent years as an alternative for parents who are concerned about the effects general anesthesia might have on their child.
Hays says there is also a growing body of data that suggests that babies who have spinal anesthesia instead of general anesthesia can have a better recovery, so even parents who aren’t concerned about general anesthesia may wish to consider the benefits of the spinal alternative.
“Studies have found that the baby typically spends about half as much time in recovery afterward, pain scores are lower, and they don’t need as much opioid because the medication we use also relieves pain,” Hays says.
To administer spinal anesthesia, local anesthetic is injected into the spinal fluid, causing the baby to go numb from the waist down.
Another benefit of spinal anesthesia that parents find especially comforting, Lockwood says, is that many babies who receive it end up falling asleep naturally.
“Once a baby is numb in the lower extremities and there is no sensory input from that part of the body, they tend to just fall asleep and stay asleep through the surgery,” Lockwood says.
Helping parents make the right choice for their child
Spinal anesthesia is not appropriate for all pediatric urology procedures. UI pediatric urologists offer it primarily for penile procedures that can be done in a short period of time, such as circumcision, circumcision revision, chordee correction, orchiopexy, hydrocele repair, and hypospadias repair.
It’s also not right for every baby. The ideal spinal anesthesia patient is 6 to 12 months old.
And the pediatric anesthesiology specialists at UI Stead Family Children’s Hospital are always prepared to convert to general anesthesia if a procedure goes too long or in cases where spinal anesthesia appears not to be working well for the patient.
Spinal anesthesia is only used after the patient’s family and their pediatric urologist have had a detailed discussion of the benefits and risks so that everyone is confident that it’s the right choice.
“That’s something our pediatric urology team really does well,” Hays says. “Talking about this option and making sure the family understands it is a crucial part of the process.”
University of Iowa Stead Family Children’s Hospital is home to Iowa’s only board specialty certified pediatric urologists.