Nerve block: Auricular

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, 5-10cc
• 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