{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T19:16:17Z","timestamp":1773342977945,"version":"3.50.1"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Non-operating room anesthesia (NORA) has emerged as one of the fastest-growing domains of modern anesthetic practice. Increasing procedural complexity and an aging, comorbid patient population demand analgesic strategies that enhance safety, comfort, and procedural success while minimizing physiological disturbance. Although systemic opioids and sedatives remain commonly used in NORA settings, their dose-dependent adverse effects may compromise patient safety and delay recovery, particularly in environments with limited postprocedural monitoring. Ultrasound-guided fascial plane blocks (FPBs) have therefore gained prominence as key components of opioid-sparing and opioid-free anesthetic strategies. By providing targeted regional analgesia with preserved hemodynamic stability, FPBs reduce systemic analgesic requirements and opioid-related side effects while improving patient comfort. This review summarizes the anatomical basis, proposed mechanisms of action, and current clinical evidence supporting the use of thoracic and abdominal fascial plane blocks in NORA settings, with particular emphasis on interventional cardiology and interventional radiology procedures. The expanding role of FPBs suggests that these techniques may become integral elements of standard analgesic protocols in contemporary non-operating room anesthesia practice.<\/jats:p>","DOI":"10.3390\/jcm15062143","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:43:18Z","timestamp":1773240198000},"page":"2143","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fascial Plane Blocks for Analgesia in Non-Operating Room Anesthesia Settings"],"prefix":"10.3390","volume":"15","author":[{"given":"Huseyin Ulas","family":"Pinar","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Hacettepe University School of Medicine, Ankara 06230, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asina","family":"Pinar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Ankara Bilkent City Hospital, University of Health Sciences, Ankara 06800, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ay\u015fe Heves","family":"Karag\u00f6z","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimation, Hacettepe University School of Medicine, Ankara 06230, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1213\/ANE.0000000000001734","article-title":"Growth of nonoperating room anesthesia care in the United States: A contemporary trends analysis","volume":"124","author":"Nagrebetsky","year":"2017","journal-title":"Anesth. Analg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/PTS.0000000000000156","article-title":"Interventional procedures outside of the operating room: Results from the National Anesthesia Clinical Outcomes Registry","volume":"14","author":"Chang","year":"2018","journal-title":"J. Patient Saf."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.anclin.2017.07.003","article-title":"Safety of non-operating room anesthesia: A closed claims update","volume":"35","author":"Woodward","year":"2017","journal-title":"Anesth. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1055\/s-0042-1745799","article-title":"Interventional radiology regional anesthesia approaches for \u0131ntra- and postprocedural pain control","volume":"39","author":"Sag","year":"2022","journal-title":"Semin. Interv. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/ALN.0000000000005790","article-title":"2026 American Society of Anesthesiologists Practice Guideline on Perioperative Pain Management Using Local and Regional Analgesia for Cardiothoracic Surgeries, Mastectomy, and Abdominal Surgeries","volume":"144","author":"Joshi","year":"2026","journal-title":"Anesthesiology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1053\/j.jvca.2021.05.037","article-title":"Safety of Ultrasound-Guided Serratus Anterior and Erector Spinae Fascial Plane Blocks: A Retrospective Analysis in Patients Undergoing Cardiac Surgery While Receiving Antiplatelet and Anticoagulant Drugs","volume":"36","author":"Toscano","year":"2022","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1111\/anae.15609","article-title":"PROSPECT guidelines for video-assisted thoracoscopic surgery: A systematic review and procedure-specific postoperative pain management recommendations","volume":"77","author":"Feray","year":"2022","journal-title":"Anaesthesia"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/anae.14964","article-title":"PROSPECT guideline for oncological breast surgery: A systematic review and procedure-specific postoperative pain management recommendations","volume":"75","author":"Jacobs","year":"2020","journal-title":"Anaesthesia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1136\/rapm-2020-101933","article-title":"Pain management after open liver resection: Procedure-Specific Postoperative Pain Management (PROSPECT) recommendations","volume":"46","author":"Dieu","year":"2021","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1111\/anae.15339","article-title":"PROSPECT guideline for elective caesarean section: Updated systematic review and procedure-specific postoperative pain management recommendations","volume":"76","author":"Roofthooft","year":"2021","journal-title":"Anaesthesia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1136\/rapm-2020-102305","article-title":"Mechanisms of action of fascial plane blocks: A narrative review","volume":"46","author":"Chin","year":"2021","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1111\/anae.15276","article-title":"Ultrasound-guided fascial plane blocks of the chest wall: A state-of the art review","volume":"76","author":"Chin","year":"2021","journal-title":"Anaesthesia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"42","DOI":"10.21037\/dmr-21-83","article-title":"Regional anaesthesia and fascial plane blocks for abdominal surgery: A narrative review","volume":"5","author":"May","year":"2022","journal-title":"Dig. Med. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3288","DOI":"10.1053\/j.jvca.2021.02.052","article-title":"Analgesic Efficacy of Regional Anesthesia of the Hemithorax in Patients Undergoing Subcutaneous Implantable Cardioverter-Defibrillator Placement","volume":"35","author":"Zhang","year":"2021","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e8374","DOI":"10.1002\/ccr3.8374","article-title":"Serratus anterior plane block and postoperative pain control in obese patients undergoing S-ICD implantation: A case series and literature analysis","volume":"12","author":"Coletta","year":"2024","journal-title":"Clin. Case Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e940541","DOI":"10.12659\/MSM.940541","article-title":"Ultrasound-Guided Pectoserratus Plane Block and Superficial Serratus Anterior Plane Block for Subcutaneous Implantable Cardioverter-Defibrillator Implantation: A Comparative Study","volume":"29","author":"Szamborski","year":"2023","journal-title":"Med. Sci. Monit."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.hrthm.2024.07.124","article-title":"Intraoperative pectoral nerve blocks during cardiac implantable electronic device procedures","volume":"22","author":"Markman","year":"2025","journal-title":"Heart Rhythm."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"424","DOI":"10.4097\/kja.22681","article-title":"Pectoral nerve blocks for transvenous subpectoral pacemaker insertion in children: A randomized controlled study","volume":"76","author":"Elhaddad","year":"2023","journal-title":"Korean J. Anesth."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"110197","DOI":"10.1016\/j.jclinane.2021.110197","article-title":"Clavipectoral fascial plane block for implantable cardioverter defibrillator implantation","volume":"71","author":"Metinyurt","year":"2021","journal-title":"J. Clin. Anesth."},{"key":"ref_20","first-page":"e88726","article-title":"Clavipectoral Fascial Plane Block for a Permanent Pacemaker Insertion in a Claustrophobic Patient with a History of Substance Abuse: A Case Report","volume":"17","author":"Sandeep","year":"2025","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1007\/s00270-025-04108-5","article-title":"Erector Spinae Plane Block for Percutaneous Transhepatic Biliary Drainage: A Comparative Analysis","volume":"48","author":"Erdim","year":"2025","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1007\/s00270-025-04135-2","article-title":"Could we Safely Perform Liver Ablation Without Deep Sedation or General Anesthesia? Preliminary Experience on Erector Spinae Plane Block (Espb) in the Management of Intra- and Post-Procedural Pain for Liver Microwave Ablation","volume":"48","author":"Lucatelli","year":"2025","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"111147","DOI":"10.1016\/j.ejrad.2023.111147","article-title":"Combined multiple regional anesthesia for microwave ablation of liver tumors: Initial experience","volume":"169","author":"Wang","year":"2023","journal-title":"Eur. J. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.carrev.2019.08.080","article-title":"Transfemoral Transcatheter Aortic Valve Replacement Using Fascia Iliaca Block as an Alternative Approach to Conscious Sedation as Compared to General Anesthesia","volume":"21","author":"Lau","year":"2020","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1177\/17085381241273306","article-title":"Comparative analysis of perioperative outcomes in endovascular abdominal aortic aneurysm repair: Fascia iliaca block versus general anesthesia, a retrospective study","volume":"33","author":"Bokerd","year":"2025","journal-title":"Vascular"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109624","DOI":"10.1016\/j.jclinane.2019.09.018","article-title":"Ultrasound guided fascia lata plane block: A novel anesthetic technique for percutaneous endovascular procedures","volume":"61","author":"Kilicaslan","year":"2019","journal-title":"J. Clin. Anest."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.2147\/JPR.S258692","article-title":"Analgesic Effectiveness of Ultrasound-Guided Pecs II Block in Central Venous Port Catheter Implantation","volume":"13","author":"Ince","year":"2020","journal-title":"J. Pain Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"112115","DOI":"10.1016\/j.jclinane.2025.112115","article-title":"The fascial plane blocks in the upper arm surgery and trauma: A narrative review","volume":"109","author":"Marrone","year":"2026","journal-title":"J. Clin. Anesth."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e1334","DOI":"10.1097\/AJP.0000000000001334","article-title":"Efficacy and Safety of Serratus Anterior Plane Block and Erector Spinae Plane Block for Rib Fracture Pain: A Systematic Review and Meta-analysis","volume":"42","author":"Lin","year":"2026","journal-title":"Clin. J. Pain"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Mirea, L., Dumitriu, A.M., Cobilinschi, C., Ene, R., and Ungureanu, R. (2025). Integrating Peripheral Nerve Blocks in Multiple Trauma Care: Current Evidence and Clinical Challenges. J. Clin. Med., 14.","DOI":"10.3390\/jcm14155598"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ajem.2024.12.029","article-title":"Regional anesthesia modalities in blunt thoracic trauma: A systematic review and Bayesian network meta-analysis","volume":"89","author":"Gamberini","year":"2025","journal-title":"Am. J. Emerg. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jemermed.2024.08.008","article-title":"Ultrasound-Guided Erector Spinae Plane Nerve Block for Relief of Acute Cholecystitis Pain","volume":"69","author":"Bowling","year":"2025","journal-title":"J. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13089-025-00461-1","article-title":"Erector spinae plane block for acute pain management of pancreatic cancer at the emergency department","volume":"17","author":"Adi","year":"2025","journal-title":"Ultrasound J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s44158-024-00213-y","article-title":"Erector spinae plane block for cancer pain relief: A systematic review","volume":"4","author":"Capuano","year":"2024","journal-title":"J. Anesth. Analg. Crit. Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"163.e1","DOI":"10.1016\/j.ajem.2024.03.001","article-title":"Ultrasound-guided erector spinae nerve block for relief of endometriosis pain in the emergency department","volume":"83","author":"Stenberg","year":"2024","journal-title":"Am. J. Emerg. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"190","DOI":"10.4103\/sja.sja_146_25","article-title":"Fascial plane blocks in pediatric anesthesia: A narrative review","volume":"19","author":"Yucal","year":"2025","journal-title":"Saudi J. Anaesth."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1136\/rapm-2024-105416","article-title":"Use of regional anesthesia within a pediatric interventional radiology suite reduced periprocedural opioid use without delaying the overall workflow: A retrospective study","volume":"50","author":"Gaelen","year":"2025","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1007\/s12630-025-03034-x","article-title":"Local anesthetic dosing for fascial plane blocks to avoid systemic toxicity: A narrative review","volume":"72","author":"Bailey","year":"2025","journal-title":"Can. J. Anaesth."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2143\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T10:13:33Z","timestamp":1773310413000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/6\/2143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,11]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15062143"],"URL":"https:\/\/doi.org\/10.3390\/jcm15062143","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,11]]}}}