title: Regional anesthesia for children undergoing orthopedic ambulatory surgeries in the United States, 1996-2006.
abstract: BACKGROUND
  Our objective was to evaluate national trends in regional anesthetic techniques among children undergoing ambulatory orthopedic procedures.
  We aimed to determine whether an increase in regional anesthetics was primarily driven by an increase in the number of peripheral nerve blocks performed rather than an increase in neuraxial techniques. We further aimed to determine whether the proportion of peripheral nerve blocks performed in conjunction with general anesthesia has increased over time.
  
  
  METHODS
  Our study sample included any pediatric patient (i.e., <18 years old) who underwent an orthopedic ambulatory procedure in 1996 and 2006. We obtained data on ambulatory surgical procedures by accessing the Centers for Disease Control and Prevention's National Survey of Ambulatory Surgery. Patient demographics (age, gender), procedure information, and anesthesia-related variables were analyzed for each year.
  
  
  RESULTS
  The proportion of peripheral nerve blocks performed for ambulatory surgery more than doubled from 1996 (4.4 %) to 2006 (8.1 %). A significantly larger proportion of orthopedic procedures were being performed with a combination of peripheral nerve blocks and general anesthesia (1.2 % in 1996 and 43 % 2006). The use of neuraxial anesthesia for lower extremity surgeries decreased over the 10-year period (1.1 and 0.4 % in 1996 and 2006, respectively).
  
  
  CONCLUSIONS
  There was a significant increase in the use of peripheral nerve blocks for children undergoing ambulatory orthopedic procedures in the USA, while neuraxial techniques became less common over the 10-year period. The peripheral nerve blocks were frequently performed in conjunction with general anesthesia.
authors.affiliation: Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Cassie
authors.initials: C
authors.lastname: Kuo
authors.forename: Alison
authors.initials: A
authors.lastname: Edwards
authors.forename: Madhu
authors.initials: M
authors.lastname: Mazumdar
authors.forename: Stavros G
authors.initials: SG
authors.lastname: Memtsoudis
keywords: ambulatory surgery; pediatrics; regional anesthesia