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Landmark-guided clavipectoral fascial plane block (CFPB) combined with sedation for clavicle implant removal: A case report

Year: 2026

Type: article

Abstract: Effective anesthesia and postoperative analgesia are essential for clavicular surgeries. The clavipectoral fascial plane block (CFPB) is a diaphragm-sparing regional technique that provides sensory blockade of the clavicle with a favorable safety profile. Although commonly performed under ultrasound guidance, a landmark-guided approach may be useful in resource-limited settings. We report an 18-year-old male undergoing right clavicular implant removal under landmark-guided CFPB with local anesthetic deposited at medial, middle, and lateral clavicular points. Sedation was provided with dexmedetomidine infusion, and intravenous paracetamol was administered pre-incision. The patient remained comfortable and hemodynamically stable throughout the 45-min procedure, with preserved spontaneous breathing and communication. Postoperative analgesia was excellent (NRS 0–2/10) with intact upper-limb motor function, enabling early mobilization and discharge on postoperative day one. This case demonstrates that landmark-guided CFPB with light sedation is a safe, effective, and practical anesthetic option for clavicle implant removal, particularly where ultrasound is unavailable. Further studies are warranted to validate its broader applicability.

Source: JCA advances.

DOI: 10.1016/j.jcadva.2026.100206

Authors: Veswudu Swuro, Satheesh Gunashekar, Priyakshi Borah, Dharitri Dutta

Institution: All India Institute of Medical Sciences Guwahati

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,200