Clavipectoral Fascial Plane Block

by | Jun 5, 2026

Stylized clavicle graphic representing the clavipectoral fascial plane block.

Indications

  • Clavicle fractures

Contraindications

  • Infection overlying injection site
  • Allergy to local anesthetic

Equipment

  • 10cc of local anesthetic of choice
    • Typically 5cc on either side of the fracture
  • 20-22G, 1.5-3.5 in spinal/nerve block needle
  • Saline Flush
  • Cleansing solution
  • Ultrasound with high-frequency linear transducer
  • Ultrasound transducer sterile cover

Preparation

Position

Position the patient supine

Ultrasound

Landmarks

  1. Place the linear probe in a sagittal plane on top of the clavicle.

Linear ultrasound probe positioned over the clavicle with sonogram labeling the clavicle, pectoralis major, and subclavius for clavipectoral block guidance.

  1. Orient the probe marker toward the patient’s head.
  2. The probe can be placed anywhere along the clavicle on either side of the fracture.

Technique

Ultrasound-guided needle approach to the clavicle with local anesthetic placement indicated in the clavipectoral fascial plane.

  1. In-plane needle visualization
  2. Advance the needle caudal-to-cranial.
  3. Enter from the inferior aspect of the probe.
  4. Aim for the 12 to 2 o’clock position on the clavicle.
  5. Deposit ~5cc of local anesthetic just on top of the clavicle.
  6. Visualize separation of the clavipectoral fascia from the periosteum.
  7. Repeat on the opposite side of the fracture if more complete analgesia is needed.

Example

Ultrasound animation showing in-plane needle placement and local anesthetic spread for a clavipectoral fascial plane block over the clavicle.

 

Source

  1. The POCUS Atlas