Health Topics

Before giving anesthesia, we will ask questions about your baby's gestational age, birth history, history of apnea and lung disease and other problems of prematurity. We will evaluate the baby's airway, heart and lung function, any congenital abnormalities and the state of hydration.

Before surgery, we may order laboratory tests including a blood count, calcium and glucose levels and clotting studies. Newborns and premature babies are usually medicated with atropine before receiving anesthesia. This helps to dry the mouth and maintain heart rate during anesthesia.

General anesthesia is usually provided initially by intravenous (IV) or mask technique, followed by placement of the breathing tube.

Anesthesia professionals will monitor your child closely during surgery. For hernia surgery, routine equipment will check on the heart's electrical activity, blood pressure, oxygen levels in the blood, body temperature and breathing (measuring inhaled oxygen and exhaled carbon dioxide concentrations). For more major surgery, a special blood pressure monitor (an arterial line) may be used to continuously monitor blood pressure. An arterial line is like a regular IV, but placed in an artery rather than a vein. Similarly, a central line may be used to monitor central venous pressure.

When possible, we reduce the need for anesthetic agents by using a nerve block, also called a caudal block. For hernia surgery, we give a single shot nerve block. For major surgery, we use continuous nerve blocks. These blocks are placed once your child is asleep and controls pain during and after surgery.

In order to reduce the risk of apnea after surgery in premature babies, caffeine is usually given by IV before anesthesia.

Healthy term babies having outpatient procedures are monitored for four to six hours before going home. Depending on their age, premature babies may be admitted overnight for monitoring for apnea.

Newborns undergoing more extensive surgery are cared for in the Newborn Intensive Care Unit. The breathing tube may be kept in these babies for a period of time after surgery to assist ventilation. Pain control is provided by continuous nerve block or by IV pain medications.