{
  "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.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA"
      ],
      "name": "John G Hagen"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada"
      ],
      "name": "Deepa Kattail"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Natalie Barnett"
    },
    {
      "affiliations": [
        "Anesthesiology, Children’s National, Washington, District of Columbia, USA"
      ],
      "name": "Robert Scott Dingeman"
    },
    {
      "affiliations": [
        "Anesthesiology, Akron Children’s Hospital, Akron, Ohio, USA"
      ],
      "name": "Cassandra Hoffmann"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Pain Medicine, American Society of Regional, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Michele Nichols"
    },
    {
      "affiliations": [
        "Department of Anesthesia and Pain Medicine, American Society of Regional, Pittsburgh, Pennsylvania, USA"
      ],
      "name": "Angela D Stengel"
    },
    {
      "affiliations": [
        "Anesthesia, Shriners Hospitals for Children Northern California, Sacramento, California, USA"
      ],
      "name": "Sampaguita Tafoya"
    },
    {
      "affiliations": [
        "University Rennes 1, Rennes, France"
      ],
      "name": "Claude Ecoffey"
    },
    {
      "affiliations": [
        "Pediatric Anesthesiology and Intensive cARE, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Italy"
      ],
      "name": "Giorgio Ivani"
    },
    {
      "affiliations": [
        "Anesthesiology, Medstar Georgetown University, Washington, District of Columbia, USA"
      ],
      "name": "Tripali Kundu"
    },
    {
      "affiliations": [
        "Physiology & Pharmacology, Karolinska Inst, Stockholm, Sweden"
      ],
      "name": "Per-Arne Lönnqvist"
    },
    {
      "affiliations": [
        "Anesthesiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK"
      ],
      "name": "Annabel Pearson"
    },
    {
      "affiliations": [
        "Anesthesiology, Mayo Clinic in Minnesota, Rochester, Minnesota, USA"
      ],
      "name": "Robert Wilder"
    },
    {
      "affiliations": [
        "Anesthesiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh"
      ],
      "name": "Debabrata Banik"
    },
    {
      "affiliations": [
        "Anesthesiology, Clinique Maissalyne, Constantine, Algeria"
      ],
      "name": "Noreddine Bouarroudj"
    },
    {
      "affiliations": [
        "Department of Anaesthesia and Pain Medicine, Flinders Medical Centre, Adelaide, South Australia, Australia"
      ],
      "name": "Cheryl S L Chooi"
    },
    {
      "affiliations": [
        "Anesthesiology, NH SRCC Children’s Hospital, Mumbai, Maharashtra, India"
      ],
      "name": "Nandini Dave"
    },
    {
      "affiliations": [
        "Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, India"
      ],
      "name": "Palanichamy Gurumoorthi"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Kathryn S Handlogten"
    },
    {
      "affiliations": [
        "Department for Anesthesiology and Intensive Care Medicine, Medical University, Graz, Austria"
      ],
      "name": "Stefan Heschl"
    },
    {
      "affiliations": [
        "The Royal Children’s Hospital Melbourne, Melbourne, Victoria, Australia"
      ],
      "name": "James Koziol"
    },
    {
      "affiliations": [
        "AIC Kijabe Hospital, Kijabe, Kenya"
      ],
      "name": "J Matthew Kynes"
    },
    {
      "affiliations": [
        "Anesthesiology, Hospital Pediatrico Pereira Rossell, Montevideo, Uruguay"
      ],
      "name": "Gabriela Lopez"
    },
    {
      "affiliations": [
        "Department of Anaesthesiology, Axon Anaesthesia Associates, SS Sparsh Hospital, Bengaluru, India"
      ],
      "name": "Amjad Maniar"
    },
    {
      "affiliations": [
        "Anesthesiology, National Hospital Abuja, Abuja, Nigeria"
      ],
      "name": "Maryrose Osazuwa"
    },
    {
      "affiliations": [
        "Department of Anaesthesia, Hinduja Health Care Surgical and Research Centre, Mumbai, India"
      ],
      "name": "Vrushali Ponde"
    },
    {
      "affiliations": [
        "Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, California, USA"
      ],
      "name": "Ban C H Tsui"
    },
    {
      "affiliations": [
        "Department of Anesthesia, Royal Victoria Hospital, Belfast, UK"
      ],
      "name": "Lloyd R Turbitt"
    },
    {
      "affiliations": [
        "Rush University Medical Center, Chicago, Illinois, USA"
      ],
      "name": "Santhanam Suresh"
    }
  ],
  "title": "Baby steps to mastery: building blocks for novices in pediatric regional anesthesia",
  "uid": "fd052e68-7f56-572d-a646-61fc61889951"
}