Pharm

Ear Nerve Block

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Ear Nerve Block, Field Nerve Block of Ear, Ear Field Block, Auricle Anesthesia

  • Physiology
  • Ear sensory innervation
  1. Greater auricular nerve
  2. Lesser Occipital Nerve
  3. Auriculotemporal nerve
  4. Lesser Occipital Nerve
  • Indications
  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
  • References
  1. Moy in Pfenninger (1994) Procedures, p. 145-55
  2. Salam (2004) Am Fam Physician 69(3):585-90 [PubMed]