A one‑year snapshot of pediatric regional anesthesia at a French Tertiary University Hospital
Abstract
Background: Regional anesthesia (RA) is a major component of multimodal perioperative analgesia in children. Despite proven benefits, pediatric RA practice shows marked inter-institutional and international variability, with global practice patterns remaining largely underreported. This study aimed to characterize current RA practices in a pediatric anesthesia department of a French tertiary university hospital. Methods: This retrospective observational study of prospectively collected data over one year included all children aged 0-18 years receiving at least one RA procedure. The data analyzed comprised demographics, surgical characteristics, RA techniques, guidance methods, and pharmacologic agents. Each RA procedure was considered an independent event, and patients were stratified into five age groups. Results: Over the study period, 907 patients (6.0 [1.0; 12.0] years) underwent 1,073 RA procedures: 894 peripheral blocks (83%) and 179 neuraxial blocks (17%). Peripheral blocks predominated in children >6 months (90%), while 59% of neuraxial RA were in infants <6 months. RA was conducted under general anesthesia in 90% of cases; awake spinal anesthesia in small infants comprised most neuraxial procedures. Ultrasound guidance was used in 98% of peripheral blocks, and pre-puncture scanning preceded 22% of neuraxial procedures. Clonidine was used as an adjuvant in >60% of cases. Conclusions: This single-center cohort reports one year of pediatric RA practice, characterized by high RA implementation rates. While ultrasound guidance was standard for peripheral blocks, pre-puncture scanning remains infrequently used for neuraxial techniques, highlighting a potential margin for improvement based on current practice. Results highlight selective neuraxial strategies in vulnerable infants and routine adjuvant use to optimize postoperative analgesia. Findings confirm RA feasibility in daily pediatric anesthesia and support multicenter studies evaluating inter-institutional variability and outcomes impact.
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BibTeX
@article{sola2026oneyear,
title = {{A one‑year snapshot of pediatric regional anesthesia at a French Tertiary University Hospital}},
author = {Chrystelle Sola and Julien Pico and Kevin Chapron and Sarah Jouan and Pierre Bournonville and Loic Rougerie and Laurent Hertz and Christophe Dadure},
journal = {Anaesthesia Critical Care \& Pain Medicine},
year = {2026},
month = sep,
doi = {10.1016/j.accpm.2026.101868},
url = {https://hal.science/hal-05643087v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A one‑year snapshot of pediatric regional anesthesia at a French Tertiary University Hospital
AU - Chrystelle Sola
AU - Julien Pico
AU - Kevin Chapron
AU - Sarah Jouan
AU - Pierre Bournonville
AU - Loic Rougerie
AU - Laurent Hertz
AU - Christophe Dadure
PY - 2026
DA - 2026/09/02
JO - Anaesthesia Critical Care & Pain Medicine
DO - 10.1016/j.accpm.2026.101868
UR - https://hal.science/hal-05643087v1
AB - Background: Regional anesthesia (RA) is a major component of multimodal perioperative analgesia in children. Despite proven benefits, pediatric RA practice shows marked inter-institutional and international variability, with global practice patterns remaining largely underreported. This study aimed to characterize current RA practices in a pediatric anesthesia department of a French tertiary university hospital. Methods: This retrospective observational study of prospectively collected data over one year included all children aged 0-18 years receiving at least one RA procedure. The data analyzed comprised demographics, surgical characteristics, RA techniques, guidance methods, and pharmacologic agents. Each RA procedure was considered an independent event, and patients were stratified into five age groups. Results: Over the study period, 907 patients (6.0 [1.0; 12.0] years) underwent 1,073 RA procedures: 894 peripheral blocks (83%) and 179 neuraxial blocks (17%). Peripheral blocks predominated in children >6 months (90%), while 59% of neuraxial RA were in infants <6 months. RA was conducted under general anesthesia in 90% of cases; awake spinal anesthesia in small infants comprised most neuraxial procedures. Ultrasound guidance was used in 98% of peripheral blocks, and pre-puncture scanning preceded 22% of neuraxial procedures. Clonidine was used as an adjuvant in >60% of cases. Conclusions: This single-center cohort reports one year of pediatric RA practice, characterized by high RA implementation rates. While ultrasound guidance was standard for peripheral blocks, pre-puncture scanning remains infrequently used for neuraxial techniques, highlighting a potential margin for improvement based on current practice. Results highlight selective neuraxial strategies in vulnerable infants and routine adjuvant use to optimize postoperative analgesia. Findings confirm RA feasibility in daily pediatric anesthesia and support multicenter studies evaluating inter-institutional variability and outcomes impact.
SN - 2352-5568
ER -