Our Summary

This study looks at the effects of different types of anesthesia on infants under 90 days old undergoing urologic surgery. The two types of anesthesia compared are spinal anesthesia (SA) and general anesthesia (GA). The research found that 80% of infants who received spinal anesthesia did not have any complications. Some had to be switched to general anesthesia as the spinal needle could not be placed correctly or the infant became agitated during the surgery. Almost all infants who received general anesthesia had to have a tube placed in their windpipe.

The study also found that infants who received spinal anesthesia were less likely to be given painkillers during the surgery and also received a lower overall dose of painkillers. They were also less likely to be given additional medications during the surgery, especially corticosteroids, which are a type of steroid hormone.

There were no significant differences in the length of hospital stay between the two groups. The researchers conclude that spinal anesthesia may be a better option for these young patients, as it avoids the need for a tube in the windpipe and the potential negative effects of general anesthesia on brain development. It also reduces the use of painkillers and other medications. This could be particularly important in cases where the benefits of surgery need to be weighed against the risks of general anesthesia.

FAQs

  1. What were the main differences found between spinal and general anesthesia in infants undergoing urologic surgery?
  2. Are there any reported complications with spinal anesthesia in infants under 90 days old?
  3. Why might spinal anesthesia be considered a better option than general anesthesia in infants undergoing surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal surgery is to follow all pre-operative instructions provided by your healthcare team, including fasting before the surgery and avoiding certain medications. It is important to discuss any concerns or questions you have with your healthcare provider and to follow their guidance for a successful recovery. Additionally, post-operative rehabilitation and physical therapy are essential for a successful outcome after spinal surgery. Be sure to follow your healthcare provider’s recommendations for rehabilitation exercises and follow-up appointments to optimize your recovery.

Suitable For

Patients who are typically recommended spinal surgery include those with severe back pain, herniated discs, spinal stenosis, scoliosis, spinal fractures, spinal tumors, and spinal deformities. Additionally, patients who have not had success with conservative treatments such as physical therapy, medication, or injections may also be candidates for spinal surgery. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if spinal surgery is the best course of action for their individual situation.

Timeline

Before spinal surgery:

  1. Patient consults with a physician to discuss symptoms and potential treatment options.
  2. Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the extent of the spinal problem.
  3. Patient may undergo physical therapy or other conservative treatments to try to alleviate symptoms before proceeding with surgery.
  4. Patient meets with a surgeon to discuss the surgical procedure, potential risks, and expected outcomes.
  5. Patient undergoes pre-operative testing and clearance from a medical team.
  6. Patient receives anesthesia in the operating room before the surgery begins.

After spinal surgery:

  1. Patient is monitored closely in the recovery room immediately following the surgery.
  2. Patient may experience pain and discomfort in the days following the surgery and will be given pain medication as needed.
  3. Patient will begin physical therapy and rehabilitation to regain strength and mobility in the affected area.
  4. Patient will have follow-up appointments with the surgeon to monitor progress and address any concerns.
  5. Patient may need to make lifestyle changes or modifications to prevent further spinal problems in the future.
  6. Patient may gradually return to normal activities and work, following the guidance of their medical team.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal surgery for my specific condition?
  2. What is the success rate of this type of surgery for patients with similar conditions?
  3. Are there any alternative treatments or less invasive procedures that I could consider before opting for spinal surgery?
  4. What is the recovery process like after spinal surgery and how long can I expect to be in the hospital?
  5. Will I need physical therapy or rehabilitation after the surgery? If so, for how long?
  6. What are the potential long-term effects or complications of spinal surgery that I should be aware of?
  7. How soon can I expect to see improvements in my symptoms or condition after the surgery?
  8. Will I need to make any lifestyle changes or modifications after the surgery to prevent further complications?
  9. What type of anesthesia will be used during the surgery and what are the potential risks or side effects associated with it?
  10. How experienced are you in performing this type of spinal surgery and what is your success rate with similar cases?

Reference

Authors: Ebert KM, Jayanthi VR, Alpert SA, Ching CB, DaJusta DG, Fuchs ME, McLeod DJ, Whitaker EE. Journal: J Pediatr Urol. 2019 Feb;15(1):49.e1-49.e5. doi: 10.1016/j.jpurol.2018.08.011. Epub 2018 Aug 17. PMID: 30201472