Infant Spinal Anesthesia Program

About the Program

Spinal anesthesia is a great alternative to general anesthesia for infants receiving surgery below the waist. The main difference between the two is that spinal anesthesia does not require systemic medication or airway instrumentation. Hear from our spinal anesthesia team about what to expect on the day of your child's surgery.

The Infant Spinal Anesthesia Program at Mass General for Children provides spinal anesthesia, also known as a spinal block, as an option for newborns and babies undergoing certain procedures of the lower body (any area of the body below the belly button).

Spinal anesthesia is a technique where the anesthesiologist administers an anesthetic into the spinal fluid with a small needle. It causes the patient to become immobile and numb from the waist down, without losing consciousness. In many cases, the infants are able to take a nap naturally after the onset of spinal anesthesia.

With this approach, infants will not be “put under” by general anesthesia, have a breathing tube placed or rely on opioid medication to undergo lower-body surgery. Those who undergo surgery with spinal anesthesia typically recover quickly and are able to eat shortly after surgery. Recovery times can vary but, in many cases, patients can be discharged within an hour of arriving at the recovery area.

Conditions We Treat

Due to limitations on where the anesthetic can be placed, spinal anesthesia is reserved specifically for inguinal and genital surgeries, e.g., hypospadias repair, correction of penile torsion or curvature, circumcision, hidden penis, hydrocele, undescended testicle and inguinal hernia.

Evaluation and Qualifications

Prior to surgery, you will meet with your baby’s surgeon and anesthesiologist to discuss the options for anesthesia, both spinal and general. During this meeting, you can expect to discuss:

• Your infant’s medical history
• Your preference for anesthetic

In order for your child to be eligible for spinal anesthesia, he or she must:

• Weigh less than 10 kg
• Be less than 10 months old
• Have no history of congenital spinal anomalies, bleeding and clotting disorders

If for any reason the spinal block cannot be performed, your surgeon will recommend general anesthesia for your child’s surgery.

General anesthesia is also safe for infants. It is administered through inhalation (gas) or intravenously (a tube placed in the vein) and involves placing a breathing tube.

What to Expect

The Pediatric Anesthesia team at Mass General for Children specializes in caring for children before, during and after surgery and other procedures. Our multidisciplinary team consists of board-certified anesthesiologists, surgeons and nurses who specialize in infant spinal anesthesia and the lower-extremity procedures that it serves.

In many cases, infants fall asleep for the duration of the surgery. For those that stay awake, our team keeps them comfortable with a pacifier or, in some cases, video entertainment. Toward the end of the surgery, parents are welcome to bring formula or breastmilk to their infant, as needed.

Our team will communicate closely with you, the parent, throughout the surgery. You will be notified when the surgery begins and when your baby leaves the operating room. You are able to reunite with them immediately following surgery.