Experience managing pain associated with supraclavicular nerves compressed by a cardiac implantable electrical device, diagnosed by the local nerve block

A 72-year-old man with ischemic cardiomyopathy was referred to undergo an implantation of a cardiac implantable electrical device (CIED). A pocket was created subcutaneously on the left anterior chest. After the operation, he complained of severe pain irradiating to his left posterior shoulder. The local anesthetic nerve block by a local infusion of mepivacaine revealed the pain was associated with the supraclavicular nerve. We re-created the pocket and shifted the generator toward the inner side, and the irradiating pain vanished. A local anesthetic supraclavicular nerve block is an important option for the diagnosis of pain after a CIED implantation.