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

Permanent pacemaker implantation in patients with severe claustrophobia and a history of substance abuse presents unique anesthetic challenges. The balance between ensuring patient comfort and avoiding the risks associated with systemic sedation or general anesthesia requires careful planning. In this report, a regional anesthetic technique, the clavipectoral fascial plane block, was used to facilitate pacemaker insertion in a high-risk individual without the need for sedatives or opioids. The anesthetic approach was supported by preoperative psychological counselling and tailored modifications to the sterile draping, allowing the patient to remain oriented and cooperative. This case underscores the value of combining regional anesthesia with empathetic, patient-centered strategies in complex perioperative scenarios.