Baby steps to mastery: Building blocks for novices in pediatric regional anesthesia Journal Article


Authors: Hagen, J. G.; Kattail, D.; Barnett, N.; Dingeman, R. S.; Hoffmann, C.; Nichols, M.; Stengel, A. D.; Tafoya, S.; Ecoffey, C.; Ivani, G.; Kundu, T.; Lönnqvist, P. A.; Pearson, A.; Wilder, R.; Banik, D.; Bouarroudj, N.; Chooi, C. S. L.; Dave, N.; Gurumoorthi, P.; Handlogten, K. S.; Heschl, S.; Koziol, J.; Kynes, J. M.; Lopez, G.; Maniar, A.; Osazuwa, M.; Ponde, V.; Tsui, B. C. H.; Turbitt, L. R.; Suresh, S.
Article Title: Baby steps to mastery: Building blocks for novices in pediatric regional anesthesia
Abstract: Pediatric regional anesthesia offers significant benefits, yet its adoption faces barriers, including perceived overcomplexity. This study aimed to identify and establish a set of core, high-value, low-complexity nerve blocks to improve perioperative pain management in pediatric patients. A four-round modified Delphi consensus study was conducted with an international panel of pediatric and regional anesthesia experts. An initial long list of regional techniques was compiled by the Steering Committee and refined through iterative input. Panelists rated each technique on a 10-point Likert scale for importance. Consensus was defined as ≥75% of panelists assigning a mean importance score of ≥8. Techniques receiving 50%-74% agreement were categorized as having strong agreement and considered for inclusion. The final selection was confirmed through a virtual roundtable discussion. Thirty-three experts representing 12 pediatric and regional societies participated. Consensus was reached on six regional techniques, with strong agreement (∗) on two additional techniques, identifying eight core pediatric regional anesthesia blocks: supraclavicular brachial plexus block, rectus sheath block, transverse abdominis plane block∗, suprainguinal fascia iliaca block∗, femoral nerve block, adductor canal block, popliteal sciatic nerve block, and landmark-based caudal block. This consensus-driven framework defines a core set of pediatric regional anesthesia techniques that balance clinical effectiveness, feasibility, and accessibility. These findings provide a practical entry point for practitioners looking to incorporate pediatric regional anesthesia into their practice, regardless of prior experience. Future efforts should focus on standardized training, implementation research, and policy initiatives to support widespread adoption and improve perioperative pain management in children globally. © American Society of Regional Anesthesia & Pain Medicine 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.
Keywords: pain, postoperative; nerve block; acute pain; pediatric anesthesia; anesthesia, regional
Journal Title: Regional Anesthesia and Pain Medicine
ISSN: 1098-7339
Publisher: BMJ Publishing Group Ltd.  
Publication status: Online ahead of print
Date Published: 2025-04-01
Online Publication Date: 2025-04-01
Language: English
DOI: 10.1136/rapm-2025-106434
PROVIDER: scopus
PUBMED: 40169358
DOI/URL:
Notes: Article -- MSK corresponding author is John Hagen -- Source: Scopus
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  1. John G. Hagen
    5 Hagen