Auricular

Indications

• Repair of lacerations
• Incision and drainage of hematoma or abscess
• Other painful procedures involving the external ear

Contraindications

• Infection overlying injection site
• Allergy to local anesthetic
• Distortion of anatomical landmarks

Equipment

• 2-5cc of local anesthetic of choice
• Syringe
• Cleansing solution
• 1.5 inch small gauge needle (25 or greater)

Preparation

Positioning

Place patient in supine or sitting position

Technique

Ring Block

Provides anesthesia to entire ear

1. Place patient in supine or sitting position
2. Disinfect skin at the base and superior aspect of ear using chosen antiseptic
3. Insert needle into the skin just inferior to the attachment of the earlobe to the head
4. Advance needle just anterior to the tragus, aspirate while advancing
5. Inject 2-3 mL of anesthetic while slowly withdrawing needle back to the original injection site
6. Redirect and advance needle posterior and superior, aspirating while advancing
7. Inject 2-3 mL anesthetic while withdrawing needle
8. Remove needle and reinsert just superior to the attachment of the helix to the scalp
9. Advance needle just anterior to the tragus, aspirate while advancing
10. Inject 2-3 mL anesthetic while withdrawing needle toward to the original puncture site
11. Redirect and advance needle posterior to the ear
12. Inject 2-3 mL anesthetic while withdrawing needle

Source

1. WikEM