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

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.