{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T19:02:54Z","timestamp":1788289374035,"version":"build-2803163510"},"reference-count":37,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Anaesth Intensive Care"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Regional anaesthesia is an essential tool in the armamentarium for paediatric anaesthesia. While largely safe and effective, a range of serious yet preventable adverse events can occur. Incidence and risk factors have been described, but few detailed case series exist relating to paediatric regional anaesthesia. Across Australia and New Zealand, a web-based anaesthesia incident reporting system enables voluntary reporting of detailed anaesthesia-related events in adults and children. From this database, all reports involving paediatric regional anaesthesia (age less than 17 years) were retrieved. Perioperative events and their outcomes were reviewed and analysed. When offered, the reported contributing or alleviating factors relating to the case and its management were noted. This paper provides a summary of these reports alongside an evidence review to support safe practice. Of 8000 reported incidents, 26 related to paediatric regional anaesthesia were identified. There were no deaths or reports of permanent harm. Nine reports of local anaesthetic systemic toxicity were included, seven equipment and technical issues, six errors in which regional anaesthesia made an indirect contribution and four logistical and communication issues. Most incidents involved single-shot techniques or a neuraxial approach. Common themes included variable local anaesthetic dosing, cognitive overload, inadequate preparation and communication breakdown. Neonates, infants and medically complex children were disproportionately represented, highlighting their inherent risk profile. A range of preventable incidents are reported relating to patient, systems and human factors, demonstrating several areas for improvement. Risk stratification, application of existing dosing and administration guidelines, and effective teamwork and communication are encouraged to ensure safe regional anaesthesia in the paediatric population.<\/jats:p>","DOI":"10.1177\/0310057x231198255","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T02:52:43Z","timestamp":1696301563000},"page":"408-421","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Incidents relating to paediatric regional anaesthesia in the first 8000 cases reported to webAIRS"],"prefix":"10.1177","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5830-6238","authenticated-orcid":false,"given":"Manisha M","family":"Mistry","sequence":"first","affiliation":[{"name":"Department of Paediatric Anaesthesia, Starship Children\u2019s Hospital, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8804-4168","authenticated-orcid":false,"given":"Yasmin","family":"Endlich","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Medicine, Royal Adelaide Hospital, Adelaide, Australia"},{"name":"Department of Paediatric Anaesthesia, Women\u2019s and Children\u2019s Hospital, North Adelaide, Australia"},{"name":"Faculty of Anaesthesia, University of Adelaide, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"bibr1-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2018.12.003"},{"key":"bibr2-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet177"},{"key":"bibr3-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000002372"},{"key":"bibr4-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03448.x"},{"key":"bibr5-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1704500105"},{"key":"bibr6-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X211060846"},{"key":"bibr7-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30116-9"},{"key":"bibr8-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31825d9f4b"},{"key":"bibr9-0310057X231198255","unstructured":"Liu CA, Lee JM. Combined Spinal Caudal Anesthesia in Infants: Case Report and Literature. In\n                      Seventh Annual Meeting of Society for Paediatric Pain Medicine\n                      ; 2020 Feb [cited 2022 Mar 31]. https:\/\/www.pedspainmedicine.org\/wp-content\/uploads\/newsletters\/2020\/fall\/ASA%20Presentations\/Combined%20spinal.html (accessed 25 August 2023)."},{"key":"bibr10-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2019.04.004"},{"key":"bibr11-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.86577"},{"key":"bibr12-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199511000-00026"},{"key":"bibr13-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-60072-7_17"},{"key":"bibr14-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354X.197333"},{"key":"bibr15-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjae.2017.11.008"},{"key":"bibr16-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogn.2016.10.007"},{"key":"bibr17-0310057X231198255","unstructured":"Medicines and Healthcare Products Regulatory Agency.\n                      Chlorhexidine solutions: reminder of the risk of chemical burns in premature infants\n                      . Drug Safety Update volume 8 issue 4, November 2014: S3; 2014. https:\/\/www.gov.uk\/drug-safety-update\/chlorhexidine-solutions-reminder-of-the-risk-of-chemical-burns-in-premature-infants (accessed 25 August 2023)."},{"key":"bibr18-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-218500"},{"key":"bibr19-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31826253f2"},{"key":"bibr20-0310057X231198255","first-page":"445","volume":"26","author":"Dontukurthy S","year":"2021","journal-title":"J Pediatr Pharmacol Ther"},{"key":"bibr21-0310057X231198255","first-page":"211","volume":"43","author":"Suresh S","year":"2018","journal-title":"Reg Anesth Pain Med"},{"key":"bibr22-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/78.5.507"},{"key":"bibr23-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep259"},{"key":"bibr24-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000446"},{"key":"bibr25-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2011.03669.x"},{"key":"bibr26-0310057X231198255","first-page":"CD011436","volume":"2","author":"Guay J","year":"2019","journal-title":"Cochrane Database Systc Rev"},{"key":"bibr27-0310057X231198255","first-page":"59","volume":"129","author":"Weller J","year":"2016","journal-title":"NZ Med J"},{"key":"bibr28-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1002\/msj.20127"},{"key":"bibr29-0310057X231198255","first-page":"31","volume":"38","author":"Hodgson RE","year":"2000","journal-title":"S Afr J Surg"},{"key":"bibr30-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000343"},{"key":"bibr31-0310057X231198255","volume-title":"Patient safety incident reporting and learning systems: technical report and guidance","author":"World Health Organization","year":"2020"},{"key":"bibr32-0310057X231198255","unstructured":"Haslam N, Bedforth N, Pandit J.\n                      Prep, Stop, Block: The new standardised operating procedure for \u2018Stop Before You Block\u2019\n                      . 2022. https:\/\/www.ra-uk.org\/index.php\/prep-stop-block."},{"key":"bibr33-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1080\/13561820600921865"},{"key":"bibr34-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.08.025"},{"key":"bibr35-0310057X231198255","unstructured":"Australian and New Zealand College of Anaesthetists.\n                      ANZCA PG07: Guideline on pre-anaesthesia consultation and patient preparation\n                      . 2021. https:\/\/www.anzca.edu.au\/getattachment\/d2c8053c-7e76-410e-93ce-3f9a56ffd881\/PG07(A)-Guideline-on-pre-anaesthesia-consultation-and-patient-preparation-PILOT-(PS07) (accessed 25 August 2023)."},{"key":"bibr36-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X211027578"},{"key":"bibr37-0310057X231198255","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002279"}],"container-title":["Anaesthesia and Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X231198255","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0310057X231198255","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0310057X231198255","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:12:45Z","timestamp":1777367565000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/0310057X231198255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,2]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1177\/0310057X231198255"],"URL":"https:\/\/doi.org\/10.1177\/0310057x231198255","relation":{},"ISSN":["0310-057X","1448-0271"],"issn-type":[{"value":"0310-057X","type":"print"},{"value":"1448-0271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,2]]}}}