ArticlePaediatric anaesthesia2026
Perspectives in Pediatric Ambulatory Anesthesia: Part 3-One Center's Evolving Regional Anesthesia Experience and Outcomes.
Article in Paediatric anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
introductionPediatric ambulatory surgery is the dominant model of surgical care in the U.S. and has impacted the practice of regional anesthesia (RA). Pediatric RA's use has expanded as a supplement to general anesthesia with the introduction of ultrasound. We wish to document RA practice changes over the last 14 years in our ambulatory surgery center (ASC).
methodsA retrospective review of RA practice from 7/2010 to 12/2024 at a free-standing pediatric ASC was performed. A commercial software system extracted de-identified, aggregated health data from the system's EMR. Using statistical process control methods, data were processed to distinguish between common and special cause variation.
resultsIncidence of peripheral nerve blocks (PNB) was 13% and increased to 35.4% (associated with ultrasound use and pudendal block standard for penile surgery). The inverse was seen with central neuraxial block (CNB), dropping from 10% of cases to 2%. At baseline 25% of cases received a single injection block, increasing three-fold (associated with ultrasound/pudendal introductions, COVID-related reduction in non-regional cases, and non-regional case volume recovery). The incidence of continuous catheter cases was 3.7% and decreased twice (associated with COVID and sports medicine catheter program closure). Anesthesia preparation time with RA decreased from 16.8 to 12.5 min (associated with ultrasound introduction, end of COVID restrictions, and sports medicine catheter program closure). The first attempt RA success rate was high (PNB-90%, CNB-83%; single injection-89%, continuous catheter-96%). PACU maximum pain and opioid use rates decreased for RA and non-RA patients. Wrong-site blocks, their root cause analyses, and improvements to the RA timeout are discussed. DISCUSSION: This review's key findings include an evolution in RA practice, which in conjunction with opioid-sparing efforts, have driven improvements in clinical outcomes. Our ambulatory pediatric RA practice may not reflect practice seen in others; thus, we do not make inferences outside our facility.
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