Ultrasound-Guided Nerve Blocks in Pediatric Emergency Medicine

CONTEXT: Ultrasound-guided nerve blocks (UGNBs) are increasingly used in the emergency department (ED) to provide effective, opioid-sparing analgesia. Although their use is well described in adult emergency medicine, the scope, indications, and safety of UGNBs in pediatric emergency medicine remain less well defined. OBJECTIVE: To characterize the published literature describing emergency physician-performed UGNBs in pediatric emergency medicine to identify trends and directions for future research. DATA SOURCES: We electronically searched the PubMed/MEDLINE, Scopus, Embase, and Wiley Cochrane libraries from database inception through March 23, 2026. STUDY SELECTION: We included original studies describing UGNBs performed in pediatric patients by emergency physicians in the ED. DATA EXTRACTION: Three authors independently reviewed included articles and abstracted data on study characteristics, patient populations, UGNB types, clinical indications, anesthetics and adjuvants, and reported adverse events. RESULTS: From an initial database search of 5917 unique articles, 37 articles were included encompassing 440 pediatric patients who received 462 UGNBs. Twenty-one different UGNB types were described, most commonly femoral nerve blocks (8 articles, 22%; 128 blocks, 28%) and fascia iliaca compartment blocks (3 articles, 8.1%; 124 blocks, 27%) for hip and femur fracture analgesia. Two self-limited UGNB-related adverse events (0.5%) were reported, with no long-term sequelae. Study designs were heterogeneous, with substantial variability in reporting practices and frequent inclusion of mixed adult-pediatric cohorts. CONCLUSIONS: Emergency physician-performed UGNBs are increasingly reported in pediatric emergency medicine. Reported complication rates are low. The overall heterogeneous and limited evidence base highlights the need for larger, prospective studies to better define the role of UGNBs in pediatric emergency care.