Ultrasound-Guided Regional Anesthesia Approach in Permanent Pacemaker Implantation

Background: When pacemakers were first introduced, their indications and implantation techniques were quite limited. Over 400,000 permanent pacemakers are implanted annually worldwide, mostly under local anesthesia (LA), which is preferred for its hemodynamic stability. However, inadequate LA often leads to excessive use of local anesthetics or analgesics. Objective: This study evaluates the efficacy of combining interscalene brachial plexus block (ISB) and supraclavicular brachial plexus block (SCBPB) as regional anesthesia (RA) techniques during permanent pacemaker implantation, compared to LA. Methods: A total of 42 patients were randomized into RA and LA groups. The RA group underwent ISB and SCBPB under ultrasound guidance, while the LA group received traditional local anesthetic methods. Results: The RA group exhibited superior pain control, reduced analgesic requirements, and higher satisfaction rates compared to the LA group. Ultrasound guidance enhanced block success rates and minimized complications. Conclusion: ISB and SCBPB offer a superior alternative to LA for pacemaker implantation, especially in patients with anxiety or insufficient LA response.