Résumé
In recent years, pediatric RA practice has evolved, with increasing use of peripheral techniques and the use of ultrasound to improve accuracy and safety. Despite the many described advantages of RA, practice varies between countries and institutions. The aim of this study is to describe RA practices in the pediatric anesthesia department of Montpellier University Hospital. Material and methods: this was a retrospective observational study carried out over a period of 1 year, in 2022, on children aged 0 to 18 who had undergone one or more RAs. The data collected included demographic, anesthetic and surgical information. Patients were classified into 5 different age groups. Results: a total of 1073 RA were performed on 907 patients. The mean age of the patients was 6.7 +/- 5.6 years, with the majority undergoing urovisceral surgery. Analyses showed a predominance of peripheral blocks (83%), with a majority of TAP blocks, compared with 17% of neuraxial blocks, of which spinal anesthesia was the most frequent. Around 90% of patients underwent RA under GA. Finally, 98% of peripheral RA were performed under ultrasound guidance and 60% of RA include the co-administration of clonidine as an adjuvant. Conclusion: this study reveals that RA techniques at the University Hospital of Montpellier favor peripheral blocks, with a notable prevalence of truncal blocks. The use of awake spinal anesthesia in children under 6 months stands out in Montpellier due to its numerous advantages, particularly regarding respiratory and hemodynamic safety compared to general anesthesia. Furthermore, ultrasound has become an essential tool for improving the precision and safety of RA, especially peripheral techniques. Although less frequently used, ultrasound in central RA shows promise for enhancing these techniques. A multicenter study in France could compare RA practices across centers, evaluating the impact of ultrasound use and the preference for peripheral blocks in pediatric anesthesia.