Re: general anesthetic vs spinal anesthetic for foot surgery:
I personally would request a spinal for lower extremity procedures.  Far lower risk of nausea and vomiting, and there is a theoretical reduction in post-op pain because the nerve fibers have been pre-emptively blocked prior to the surgical insult.  Also no airway manipulation so no sore throat.  Overall would likely feel more alert and less drowsy immediately post-op.

Baby can of course breastfeed as soon after surgery as mom feels up to it, but she will likely feel "better" far more quickly following a spinal.  Also, if she is hesitant about being awake for the surgery, most anesthesiologists will also titrate in small amounts of sedation meds so she is comfortable throughout.  Certainly if she *really* does not want to have a spinal and would rather do a general anesthestic, that is always an option too.

Post-op opioids are of greater concern to a nursing infant than effects of general anesthesia -- Lactmed recommends total daily max dose of 30mg oxycodone in 24hrs.

Good luck to this mom!
-Sarah Reece-Stremtan (anesthesiologist who would ALWAYS chose a regional technique over general anesthesia if available, in order to reduce post-op nausea and vomiting)

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