Difference between revisions of "Nerve block: Auricular"
| Line 16: | Line 16: | ||
==Equipment== | ==Equipment== | ||
| − | *Syringe, 5- | + | *Syringe, 5-10 mL |
*Needle, 25-27 gauge | *Needle, 25-27 gauge | ||
*Local anesthetic (e.g. [[lidocaine]] 1%, [[bupivacaine]] 0.25%) | *Local anesthetic (e.g. [[lidocaine]] 1%, [[bupivacaine]] 0.25%) | ||
| Line 22: | Line 22: | ||
*Antiseptic (e.g. Betadine, Chlorhexidine, Alcohol) | *Antiseptic (e.g. Betadine, Chlorhexidine, Alcohol) | ||
*Sterile gloves | *Sterile gloves | ||
| + | *Sterile drape | ||
| + | *Gauze | ||
| + | |||
| + | ==Technique== | ||
| + | ===Ring block=== | ||
| + | *Provides anesthesia to entire ear | ||
| + | #Place patient in supine or sitting position | ||
| + | #Disinfect skin at the base and superior aspect of ear using chosen antiseptic | ||
| + | #Insert needle into the skin just inferior to the attachment of the earlobe to the head | ||
| + | #Advance needle just anterior to the tragus, aspirate while advancing | ||
| + | #Inject 2-3 mL of anesthetic while slowly withdrawing needle back to the original injection site | ||
| + | #Redirect and advance needle posterior and superior, aspirating while advancing | ||
| + | #Inject 2-3 mL anesthetic while withdrawing needle | ||
| + | #Remove needle and reinsert just superior to the attachment of the helix to the scalp | ||
| + | #Advance needle just anterior to the tragus, aspirate while advancing | ||
| + | #Inject 2-3 mL anesthetic while withdrawing needle toward to the original puncture site | ||
| + | #Redirect and advance needle posterior to the ear | ||
| + | #Inject 2-3 mL anesthetic while withdrawing needle | ||
Revision as of 23:41, 6 September 2017
Background
- External ear innervated by four sensory nerves
- Greater auricular nerve
- Lesser occipital nerve
- Auricular branch of vagus nerve
- Auriculotemporal nerve
- Provides anesthesia to the entire ear without distorting anatomy
Indications
- Repair of lacerations
- I+D of hematoma or abscess, or other painful procedures involving the external ear
Contraindications
- Infection at injection site
- Allergy to chosen anesthetic
Equipment
- Syringe, 5-10 mL
- Needle, 25-27 gauge
- Local anesthetic (e.g. lidocaine 1%, bupivacaine 0.25%)
- Lidocaine with epinephrine may be used for regional block, but epi should not be used for direct infiltration of the ear
- Antiseptic (e.g. Betadine, Chlorhexidine, Alcohol)
- Sterile gloves
- Sterile drape
- Gauze
Technique
Ring block
- Provides anesthesia to entire ear
- Place patient in supine or sitting position
- Disinfect skin at the base and superior aspect of ear using chosen antiseptic
- Insert needle into the skin just inferior to the attachment of the earlobe to the head
- Advance needle just anterior to the tragus, aspirate while advancing
- Inject 2-3 mL of anesthetic while slowly withdrawing needle back to the original injection site
- Redirect and advance needle posterior and superior, aspirating while advancing
- Inject 2-3 mL anesthetic while withdrawing needle
- Remove needle and reinsert just superior to the attachment of the helix to the scalp
- Advance needle just anterior to the tragus, aspirate while advancing
- Inject 2-3 mL anesthetic while withdrawing needle toward to the original puncture site
- Redirect and advance needle posterior to the ear
- Inject 2-3 mL anesthetic while withdrawing needle