Nerve block: Auricular

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  • 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


  • Repair of lacerations
  • I+D of hematoma or abscess, or other painful procedures involving the external ear


  • Infection at injection site
  • Allergy to chosen anesthetic


  • 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