Infant surgery without pain management?

In my previous 10 posts I have written about my first surgery back in 1945, in the Netherlands, and at the age of just 10 days. In those posts I shared the several unknowns around that surgery, a pyloromyotomy to remedy infant pyloric stenosis (“PS”), nowadays regarded as a relatively minor, effective, and very safe “procedure”.

* Was I given an anesthetic or not? If so, what kind and how much?
* How did 2 or more weeks of separation from my mother affect her and me?
* What caused my parents’ silence about my first serious life story?
* Why did I develop a rather dark obsession about whatever happened?
* How do I understand many of the emotions I grew up with and resembling PTSD?
* Why did these matters bedevil me so long into my adult years?

Only with the advent of the internet was I able to break out of my information cocoon and inner turmoil. Others were able to access various therapies with a range of success. I was satisfied with finding others via the web with a similar early history and (lo and behold!) a variety of similar life-affecting symptoms.

At first my internet linking was with individuals who like me were discovering the power of the internet to share and explore common interests and concerns, to share some of our inner struggles, and to use the (then) new social media to build and interact with much larger groups with a common interest or concern.

By the first decade of the 21st century I had found several individuals with whom I had PS, experiences, and emotions in common. We learnt from each other and became more confident in our self-diagnoses and sometimes effective ways forward.

Early in the 2nd decade (the 2010s) our little group discovered professionals in psychology, psychiatry, other branches of brain science, and in counseling who were helping traumatised children. Some had begun to offer therapy programs for those who were continuing to be affected by infant and childhood trauma. I mentioned Dr Louis Tinnin in a previous post.

By then our little group had also discovered the work of Dr K J S Annan, an American medical researcher who in 1987 published his findings on the possible long-term effects of doing surgery on under 2 year olds without anesthesia and without regard to the effects of the pain this inflicted on a very small baby.

Until Dr Anand published his findings, there was a virtual total silence about this subject. Much of the medical world lived by the mantra, “Infants under 2 years old can neither feel nor remember pain.” Parents and the media were kept in the dark about what the medical world knew… or chose to stay there, perhaps?

The original anesthetic gases which worked acceptably well for adults were very hazardous when given to under 2’s. Despite this a small minority of surgeons had discovered how to navigate the dangers of giving the then available anesthetic gases to infants. Pediatric anesthesia and surgery began to be developed as medical specialties only after World War 2, and only very slowly. Much infant surgery continued to be done by general surgeons with little care for the special needs of working with little people.

Before the 1990s there were a number of options to control a baby during surgery, these depending on the attitude, practice, and skillset of the surgeon. They ranged from full physical restraint and a drug to paralysise the infant – and no pain management. They might include a sugar cube laced with alcohol for the baby to suck on. Other surgeons used local anesthetic injected as deemed necessary to minimise pain during the most painful stages of the procedure. If used, total anesthesia was administered very sparingly, usually only at those stages regarded as essential.

At about the same time our little network came across a budding and younger film-maker who had also had infant surgery (several surgeries in fact) and was living with similar emotions and inner turmoil. He proposed using his interest and developing skills to create a documentary video suitable for posting on YouTube.

During late 2016 and early 2017 this US film-maker recorded interviews and started work on a video to increase awareness of what Dr Anand had revealed: the fact that before 1987 (and for some years after this) infant surgery was often or sometimes done with inadequate or no anesthesia.

After some delay due to unrelated causes Roey Shmool’s 58 minute documentary, entitled Cutdown, has now been released on YouTube and can be found at https://www.youtube.com/watch?v=PX6LNHUX7zo&t=671s