II. Physiology: Ear sensory innervation

  1. Greater auricular nerve
  2. Lesser Occipital Nerve
  3. Auriculotemporal nerve
  4. Lesser Occipital Nerve

III. Technique: Field Block

  1. Prepare skin with betadine, hibiclens or Alcohol
  2. Draw up 12 cc anesthetic (fill 10 cc syringe beyond marker)
    1. Lidocaine 1% without Epinephrine OR
    2. Bupivicaine 0.25% without Epinephrine
  3. Block forms diamond shape encompassing ear
  4. Identify 2 injection sites
    1. Midline superior (1 cm above the ear)
      1. Insert the needle and direct anteriorly
        1. Inject 3 cc anesthetic while withdrawing the needle (so needle tip is still within skin)
      2. Redirect needle posterioly
        1. Inject 3 cc anesthetic while withdrawing the needle
    2. Midline inferior (1 cm below the ear)
      1. Repeat the same technique as for the superior injection

V. References

  1. Moy in Pfenninger (1994) Procedures, p. 145-55
  2. Salam (2004) Am Fam Physician 69(3):585-90 [PubMed]

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