RESEARCH BRIEF

Using a relatively new drug, two Harvard physicians recently demonstrated that deep anesthesia for infants undergoing major surgery is safe, and lessens hormonal and metabolic responses to cardiac surgery stress.

Clinical Fellow in Pediatrics Dr. Kanwaljeet J. S. Anand of Massachusetts General Hospital and Associate Professor of Anaesthesia Dr. Paul R. Hickey of Boston Children's Hospital were able to show that he administration of high-dose sufentanil, an opioid anaesthetic, reduced post-operative complications and mortality among infants undergoing cardiac surgery.

Earlier drugs inducing deep anaesthesia often caused problems with the infants' cardiovascular and respiratory systems. Anand and Hickey showed sufentanil to generate lower levels of stress-associated hormones and to produce stronger metabolic responses.

The doctors also refuted the widely held belief that infants and adults respond differently during surgery. Using new analysis techniques to study Chemicals in infants' blood, Anand and Hickey demonstrated that small babies do in fact produce large hormonal and metabolic strees responses.

Such responses are similar to those experienced by adults during surgery. However, Hickey says, the lack of established knowledge of the conscious experiences of infants means, there is no way to know whether they experience pain, although one might infer that the physiological changes are indicative of pain.

Because of the study's small size, Hickey said, its results will need to be verified by other researchers. The hormonal and metabolic effects of the drug must also be examined more closely.

While such studies are currently being conducted on both infants and adults, sufentanil is already in use in many hospitals around the country, and may make it possible to perform surgery on infants who would have otherwise died.