Fascial plane blocks in pediatric patients

Pediatric perioperative pain management remains challenging, and opioid-related adverse effects have driven interest in opioid-sparing strategies. Thus, regional anesthesia techniques are an increasingly important component of multimodal analgesia and may contribute to improved pain control and reduced opioid-related systemic effects. The rapid advancement of ultrasound-guided regional anesthesia has broadened the use of pediatric fascial plane blocks. These approaches offer technically straightforward, safe, and effective analgesia across a range of thoracic and abdominal procedures. However, these developments have not translated uniformly into clinical adoption. The practice of pediatric regional anesthesiology is variable and institution dependent. The lack of standardized recommendations raises safety concerns as the current evidence is limited by heterogeneity in study design and procedural variability. Age-related differences in anatomy, physiology, and pharmacokinetics limit extrapolation from adult data and present challenges in clinical application. Although complication rates are low, the risk of local anesthetic systemic toxicity and conservative dosing practices are important considerations. This narrative review discusses the mechanisms, indications, and clinical applications of fascial plane blocks in pediatric patients and highlights key factors for their safe and effective implementation.