A narrative review on fascial plane blocks – Part B: Clinical applications, practical considerations, and future directions

Fascial plane blocks (FPBs) have rapidly expanded from regional anaesthesia adjuncts to versatile analgesic tools across perioperative, emergency, and chronic pain settings. Building upon the anatomical and mechanistic foundations outlined in Part A, this Part B translates theory into practice by presenting a region-wise, surgery specific, and scenario-focused synthesis of FPB applications. We outline evidence based block selection for thoracic, abdominal, hip, pelvic, and limb procedures, while integrating their roles in trauma care, rib and clavicle fractures, and acute pain management. Practical ultrasound-guided "tips for success", landmark-based fallback strategies, and dosing considerations are consolidated into user-friendly clinical tables. Safety optimisation, including volume management, toxicity prevention, catheter techniques, and adjuvant use, is discussed with an emphasis on real-world feasibility. Persistent challenges such as sensory analgesia mismatch, variable spread, inconsistent visceral coverage, and operator dependency are critically evaluated to guide future innovation. By bridging anatomical insights with pragmatic decision making, this review empowers clinicians to adopt a "right FPB for the right surgery" approach and standardise FPB practice across diverse patient populations.