Painkillers Recommended for Surgery on Premature Babies

Doctors who use little or no anesthesia in operating on premature infants may mistakenly believe newborns don’t feel pain the way adults do, the American Academy of Pediatrics said in recommending that painkillers be used.

Many doctors have traditionally avoided using the strong drugs on newborns, especially premature babies, during surgery, said Dr. Ronald Poland, chairman of the academy’s Committee on Fetus and Newborn.

Poland said many doctors have withheld anesthesia because they believed the part of the infants’ brains that responds to pain was less developed than in older children or adults.

“There has been some feeling that newborns, and especially very small babies, might not feel as much pain and might not remember it later,” said Poland, a neonatologist at Detroit Medical Center.

The academy, in a policy statement published in the September issue of the journal Pediatrics, said recent research shows that even premature babies are capable of feeling deep pain during surgery.

The academy, based in the Chicago suburb of Elk Grove Village, recommended using general anesthesia wherever possible when operating on babies and said operating on premature babies without painkillers may cause undue stress.

Procedures often performed on babies without general anesthesia or with only local painkillers include circumcisions and even abdominal and heart surgery, said Dr. James Strain, the academy’s executive director.

Premature infants, whose respiratory or cardiac systems may be underdeveloped, are most likely to need the more serious surgery.