Spinal Anesthesia for Babies

Overview

What Is Spinal Anesthesia?

Spinal anesthesia is a type of regional anesthesia used to block pain in the lower part of the body. It involves using a thin needle to inject a small amount of medicine into the lower back (into the fluid around the spinal cord) to numb the nerves in the lower half of the body. 

Spinal anesthesia is a safe and effective alternative to general anesthesia for babies who need surgery below the belly button.

Why Is Spinal Anesthesia a Good Alternative to General Anesthesia?

Spinal anesthesia is just as effective as general anesthesia, but it’s considered safer for children because it doesn’t require the use of strong sedative (sleep-inducing) medicines or breathing tubes, both of which are often used during general anesthesia.

It also avoids the risks of general anesthesia on brain development that can happen to children under 3 years old, especially babies less than 1 year old. Some studies suggest that repeated use of general anesthesia or being under general anesthesia for more than three hours may affect brain development in children under three years old, though research is ongoing.

Top Things to Know

• Spinal anesthesia can be a safer alternative to general anesthesia for babies who need certain types of surgery, especially when babies are born early or have other health conditions.
• It’s used for procedures below the belly button that will last less than 90 minutes.
• The effect wears off in a few hours.
• Babies who get spinal anesthesia can feed immediately after the procedure and go home sooner than those who get general anesthesia.

Who Gets Spinal Anesthesia?

Doctors may recommend spinal anesthesia for infants under 18 months old during surgeries below the belly button, such as:

• Hernia repair, a surgery where a doctor carefully moves any tissue or organ that has slipped through a weak spot in a muscle and places it back to where it belongs.
• Circumcision, a procedure where a doctor removes the foreskin (the loose skin that covers the tip of the penis).
• Leg procedures, which include any type of surgery or procedure to fix a problem with the legs.

What to Expect With Spinal Anesthesia

Before the Procedure

Your baby’s surgeon or anesthesiologist will talk to you about what to expect during anesthesia. You will also be asked if your baby has had a recent illness or takes any medicines. It’s important to answer these questions as best as you can.

Before the surgery, a nurse may apply a numbing cream to your baby’s back, so your baby won’t feel any pain from the shot. Some babies may also get a calming medicine sprayed into the nose to help them relax before and during the procedure.

During the Procedure

Your baby will be gently held in a curled-up position to help the anesthesiologist find the right spot in the lower back. Then, a tiny needle will be used to inject the anesthesia into the spinal fluid. The process is quick and usually takes just a few minutes.

Your baby’s heart rate, breathing, and oxygen levels will be closely watched during the procedure. If needed, some babies receive an additional mild sedative (calming medicine) to help them stay calm and still, though most fall asleep almost right away and sleep through the whole surgery. A member of the care team will always be there to help comfort, monitor, and distract your baby throughout the procedure.

After the Procedure

After surgery with spinal anesthesia, your baby may be sleepy or fussy. You’ll be able to feed your baby right away (unlike with general anesthesia, which usually requires a longer wait). As the medicine wears off, babies will be able to move their legs within 2 to 4 hours, though they may have some mild soreness or bruising on their back for a few days.

The care team will monitor your baby closely after the procedure to ensure a smooth recovery, and you will most likely be able to go home within an hour. Talk to your doctor about how long it will take for your baby to recover from the procedure, and make sure to schedule and attend any needed follow-up appointments. 

When to Call the Doctor

Spinal anesthesia is safe for young children, and they usually recover well. But call the doctor if something doesn’t seem right after the procedure, or if:

• your baby doesn't start moving the legs within 2-4 hours
• the area where the procedure was done becomes red, swollen, or starts to leak cloudy fluid
• your child is very sleepy and hard to wake up, even hours after the procedure

What Else Should I Know?

To help your baby during before the procedure, remember:

• Stay positive and reassuring — your baby can sense your emotions.
• Ask questions and speak up about any concerns.
• Bring along comfort items to help your baby stay calm.

It’s natural to be nervous when your little one needs surgery, but remember that spinal anesthesia is very safe. Talk to your doctor about any questions or concerns you may have.