The frequency of pain management practices and the use of regional anesthesia techniques in pediatric patients: A national survey

Objective: This study aims to evaluate the attitudes, practices, and clinical approaches of anesthesiologists in Türkiye regarding pediatric regional analgesia, considering variables such as age, academic title, training institution, and clinical experience. Additionally, it identifies the barriers to implementation and the preferred techniques in pediatric surgeries. Materials and Methods: This multicenter, prospective study was conducted following approval from the Ethics Committee. An online survey was distributed to anesthesiologists in at least 10 university hospitals and 10 training and research hospitals. A total of 163 physicians participated. The first part of the survey collected sociodemographic data, while the second part included 36 questions regarding clinical practices, preferred block types, complication rates, and postoperative analgesic preferences in pediatric patients. Results: Of the participants, 81.6% reported administering anesthesia to neonates. Physicians over the age of 40, those with academic titles, and those trained in university hospitals were more frequently involved in younger age groups, major surgeries, and high ASA score patients. While caudal block was more commonly preferred among experienced physicians, younger participants reported higher usage of modern blocks such as TAP, QL, and ESP, especially under ultrasound guidance. The most frequently reported complication was hemodynamic instability, with local anesthetic toxicity being a notable risk in neonates. The main advantages of regional analgesia were effective pain control and reduced opioid use. Reported barriers included lack of experience, insufficient training or equipment, and concerns from patients or their parents. Conclusion: Pediatric regional analgesia practices are becoming increasingly widespread in Türkiye. Preferences vary depending on practitioner profile. Enhancing training programs and improving access to equipment are essential for promoting safer and more effective application of regional techniques. Keywords: Pediatric anesthesia, regional analgesia, caudal block, TAP block, ESP block, ultrasound guidance, pain management, Türkiye, educational differences