Port wine stain treatment - General Anaesthesia

drakes · #1 06-24-2008, 02:18 AM

Our newborn (4 week old) son has a port wine stain on his right hand, arm and shoulder.

We began looking into getting treatment for his stain using Pulsed Dye V-Beam laser.

In the process of speaking with different dermatologists we are faced with a dilemma regarding Anaesthesia.

Being that the treatment may run anywhere between 10-20 sessions, we are very concerned about the baby being "put under" so many times.

does anybody know if these treatments can be given without the use of a general anaesthesia?

Thank you in advance.

Aaron
Toronto, ON

nickbar · #2 06-24-2008, 03:21 PM

Hello,

There are physicians that will do laser without g.a. It typically depends on the location of the pws and how large the area to treat will be. Some doctors use topical numbing agents; however they often reduce the effectiveness of the tx. Using a local anesthetic is an option as well (injected).

I would talk with your treating physician about your options and how long your baby would be under g.a. Typical laser tx sessions are less then 15 min. total sedation... with the actual laser tx. itself being only a few minutes.

Corinne

drakes · #3 06-24-2008, 07:07 PM

we still have a couple of meetings with different physicians before we make a decision.

Sue · #4 06-25-2008, 02:32 PM

My daughter has a port wine stain on her left hand, arm & shoulder. She is now 15 months old. She has had two laser surgerys done. Both times she was under G.A. She did fine with both. I have the same concerns as you do, but with it being such a big area the dr. thought this was the best way. She was 6 months old when she had her first treatment. Please keep me informed.... I hardly ever see anyone with the portwine stain on the arm and hand. If you have any more questions please feel free to contact me.
Thanks

momofAddie · #5 06-29-2008, 03:20 PM

Hi. My daughter has received six treatments, all under general anesthesia. Her first was at 4 months of age. I am a sedation nurse at a pediatric cancer hospital. We have some patients that receive general anesthesia every day, five days a week, for six to eight weeks. They do beautifully. My daughter has had no complications at all. The anesthesia that they use is usually a gas that they breath through a mask. They are literally only under for approximately 10 minutes at the most. They do not require a breathing tube or an IV. I struggled with the decision myself, but in the end decided for her to have general anesthesia due to the need for so many treatments. If the hospital or surgery center is pediatric only, the anesthesia staff should be very comfortable with taking care of children. If it is an adult facility that does pediatric patients, I would questioned whether the staff has been pediatric trained. Also, how many pediatric patients do they do in a week's time, etc. Also, starting at age 9 months, they started giving her Versed by mouth prior to taking her back to the OR. I highly recommend this because she goes freely with the nurse and the Versed also helps her not remember the separation. I hope this eases some of your fears and good luck!

Superchikk · #6 07-25-2008, 12:53 AM

Our son has had one treatment at 8 months old, but he didn't seem phased at ALL by the anesthesia. The doctors used a gas with a mask, no tube, IV, or anything. By the time we got to recovery, he was up and playing.

His second treatment is coming up in two weeks, and we are hoping for the same.

Basically we decided that since it is not invasive, for a short period of time, and hardly any side effects, it's the way to go for us.

Lorie J · #7 07-25-2008, 07:07 PM

Hello. My son has a small port wine stain on his forehead, approx nickel sized. His treatments take about 10-20 seconds. He has had 4 treatment, all without general anesthesia. We have always used numbing cream and something by mouth to relax him. He is 2years old. I am a registered nurse, and feel at this time we made the right decision. He crys and does not like to be held down, but it's only a few seconds. As soon as we pick him up, he stops crying. By the time we get to the car, he acts as if nothing has happened. This is a very personal decision for the parents, and something I too struggled with. If he treatments took more than just a few seconds we would go with the G.A.

I hope this helps. Good Luck

lspressler · #8 08-13-2008, 02:23 PM

My DD has had three tx w/o GA. Her PWS is small and on her upper lip. The entire process takes seconds and we decided it wasn't worth the GA. She stops crying immediately after she is no longer held down. It feels like a rubber band being popped so not great but she honestly is fine as soon as we get to her. But if it was a large area then we would obviously do GA. Good luck to you!

Laura
Mommy to Sela and Noah

Melaina'sMommy · #9 10-06-2008, 11:00 PM

My daughter is now 4yrs old and has gone under 18 times for laser treatments since she was one. Her pws is rather large and on her face/eye area so her doctor would not treat her without ga. She has never had a bad reaction to the ga and is a perfectly normal 4yr old. She's usually under for 10mins or so and comes out of ga really fast. She does usually vomit a little bit during the car ride home but we drive for 5hrs after a treatment to get to our state and the motion probably is what is making her sick. I did read somewhere (can't remember where) an article about using ga that indicated that if it is a large area to be lasered and no ga is used, the child could possibly have a seizure from the pain/trauma associated with the treatment. You might want to research that possibility depending on how large the treatment area is.

michelle.karim · #10 11-29-2008, 01:22 PM

My son is 12 years old, has a PWS on his left hand and arm and has just started treatment at Great Ormond Street Hospital in London. We did not give him the treatment when he was younger as we were concerned about the number of times he would have to have anaesthetic (they estimated 10). We were told there was no problem delaying until he was old enough for them to use a local anaesthetic cream and for him to sit still during the process. He says he barely feels the laser (he had 43 shots on his first visit last week), but it is now sore two days later. We have been given dressings to apply with Diprobase cream and told to use iced water if it becomes sore. Hope this helps and good luck with your decision.