Better for babies

A pioneering alternative to general anesthesia is drawing national attention

A video of 6-month-old Mira Barr tells the story. She’s lying down, dozily sucking a pacifier and gently holding someone’s finger – not what you’d expect of a child undergoing a hernia operation.

Her peaceful experience is provided by a pain blocker being administered through her spine, a technique pioneered at the UVM Children’s Hospital in the 1970s that’s a dramatic departure from the standard practice – then and now – of putting infants to sleep with general anesthesia administered via a tube inserted through the throat.

“It all started because of one premature baby who was too sick to handle general anesthesia,” explains Robert Williams, MD, pediatric anesthesiologist at the UVM Children’s Hospital. “Dr. Chris Abajian, our lead anesthesiologist at the time, tried spinal as a substitute and liked the results, so we started using it for surgeries below the abdomen on babies less than a year old. We now have more experience with the technique than any center in the world.”

Thousands of operations have confirmed the approach is safe, effective and better for babies.

It decreased a lot of anxiety that she was able to suck her pacifier and look at people during surgery and not have the experience of being under.

Lisa Barr, Mother

“A global study recently confirmed what we’ve seen all along – shorter surgeries and fewer post-op problems with breathing and blood pressure. And because the baby doesn’t need any time to recover from ‘going under,’ the mothers are able to feed them immediately,” says Williams, also a professor at Larner College of Medicine.

“It decreased a lot of anxiety that she was able to suck her pacifier and look at people during surgery and not have the experience of being under,” said Lisa Barr, mother of Mira.

So why haven’t other hospitals switched to spinal? Williams thinks it’s because surgical teams were largely unaware of the option and saw no problems with the status quo.

“That changed 10 years ago, when studies raised concerns that infant exposure to general anesthesia might lead to brain impairments later in life,” says Williams.

And although the jury is still out on that question, he and his colleagues feel compelled to boost awareness of an alternative that poses no such concerns – something he’s confirmed through his own research – and provides a better experience for babies and their families.

An article in the Wall Street Journal (PDF) and other attention has led to speaking invitations for Williams and visits to Vermont by anesthesiologists from around the U.S. eager to learn the spinal technique.

“To be clear, we are not saying that general anesthesia is unsafe. We’re just trying to spread the word about what we know to be a better option in the right circumstances,” he added.

Learn more about pediatric sedation at the UVM Children’s Hospital.