Regional Anesthesia for Children Undergoing Orthopedic Ambulatory Surgeries in the United States, 1996–2006

Cassie Kuo, MD
Department of Anesthesiology, Hospital for Special Surgery

Alison Edwards, MStat
Division of Biostatistics and Epidemiology, Weill Cornell Medical College

Madhu Mazumdar, PhD
Division of Biostatistics and Epidemiology, Weill Cornell Medical College

Stavros G. Memtsoudis, MD, PhD



Our objective was to evaluate national trends in regional anesthetic techniques among children undergoing ambulatory orthopedic procedures.

Purpose and Questions

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.

Patients and 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.


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).


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.

This article appears in HSS Journal: Volume 8, Number 2.
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About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


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