II. Physiology: Ear sensory innervation
- Greater auricular nerve
- Lesser Occipital Nerve
- Auriculotemporal nerve
- Lesser Occipital Nerve
III. Indications
IV. Technique: Field Block
- Prepare skin with betadine, hibiclens or Alcohol
- Draw up 12 cc Anesthetic (fill 10 cc syringe beyond marker)
- Lidocaine 1% without Epinephrine OR
- Bupivicaine 0.25% without Epinephrine
- Block forms diamond shape encompassing ear
- Identify 2 injection sites
- Midline superior (1 cm above the ear)
- Insert the needle and direct anteriorly
- Inject 3 cc Anesthetic while withdrawing the needle (so needle tip is still within skin)
- Redirect needle posterioly
- Inject 3 cc Anesthetic while withdrawing the needle
- Insert the needle and direct anteriorly
- Midline inferior (1 cm below the ear)
- Repeat the same technique as for the superior injection
- Midline superior (1 cm above the ear)
V. Resources
- LacerationRepair.com (Brian Lin, MD)
VI. References
- Moy in Pfenninger (1994) Procedures, p. 145-55
- Salam (2004) Am Fam Physician 69(3):585-90 [PubMed]
