Clavipectoral Fascial Plane Block for a Permanent Pacemaker Insertion in a Claustrophobic Patient With a History of Substance Abuse: A Case Report

Sandeep G, Singha S K, Nazir S, et al.

Cureus. 2025;17(7):e88726. doi:10.7759/cureus.88726

This case report describes the use of a clavipectoral fascial plane block (CPFB) as the sole anesthetic technique for permanent pacemaker insertion in a patient with severe claustrophobia and a history of polysubstance abuse. Given the elevated risks of systemic sedation—including respiratory depression and unpredictable drug responses—the anesthesia team opted for a regional block combined with psychological support and modified sterile draping. The procedure was completed without pain or sedation, and the patient remained hemodynamically stable and cooperative throughout. This case supports CPFB as a valuable anesthetic option in select high-risk patients and emphasizes the importance of personalized, patient-centered perioperative care.

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Thank you to Cureus for making this insightful case report available and for promoting the open sharing of knowledge in regional anesthesia and perioperative care.