Many factors have contributed to the wide diffusion of regional anesthesia in children: the awareness of pain and the subsequent need for adequate pain relief at any age—from premature babies to adolescents—the demonstration of the efficacy of regional anesthesia in controlling stress, the vast amount of information coming from congresses, and books and papers on this topic. Notwithstanding the criticism surrounding the use of a “double anesthesia” (most blocks in children require sedation or light anesthesia before performing the block) with the supposed “double risk,” evidence from the world of pediatric anesthesia has demonstrated that regional anaesthesia in children is safe. Safety depends on experience and adequate guidelines, but also on the choice of drugs, whose main characteristic must be a reduced toxicity, and on a multimodal approach, which allows low concentrations of multiple drugs for a synergistic action. Some regional blocks, such as caudal blocks, epidural blocks, or penile blocks, have already an established place in pediatric anesthesia, mainly as techniques of postoperative analgesia. Peripheral nerve blocks are not yet as popular but the interest in this technique is growing due to their safety, efficacy, and well-limited localization of analgesia/anesthesia.

Regional anesthesia performed on children presents some differences to that performed on adults because of particular pediatric issues; therefore, to perform peripheral blocks in children some differences from the practice in adults should be considered.