Background and Aims The onset of the coronavirus 2019 (COVID-19) pandemic brought together the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the European Society of Regional Anaesthesia and Pain Therapy (ESRA) to release a joint statement on anesthesia use (1). Their statement included a recommendation to use regional anesthesia whenever possible to mitigate the risk associated with aerosolizing procedures. We sought to examine the utilization of anesthesia in pediatric patients undergoing a surgical procedure for fracture or ligament repair before and during COVID-19.

Methods This study is approved by Hospital for Special Surgery Institutional Review Board (IRB# 2016–436). We used the Premier Healthcare Database to identify pediatric patients undergoing a surgical intervention for fractures or ligament repair before COVID-19 (March-June 2019) and during (March-June 2020). We compared general, regional, and combined general-regional use before and during COVID-19.

Results We identified 6,415 patients undergoing a surgical procedure for fracture or ligament repair before and during COVID-19. After exclusions for unknown anesthesia use, 3,052 patients were included in our cohort with 82.9% (n=2,530) of patients undergoing a procedure under general anesthesia, 6.0% (n=182) under regional anesthesia, and 11.1% (n=340) under combined general-regional anesthesia. There was no difference in the type of anesthesia used before and during COVID-19 (p=0.053, Table 1).

Conclusions We did not find a significant difference in anesthesia use before and during COVID-19 among pediatric patients undergoing a surgical procedure. The significance of these findings highlights how societal recommendations and historical precedent may not influence pediatric anesthesia practice models.