Auricular field block

A regional auricular block is indicated for repair of extensive auricular lacerations or to avoid local tissue distortion when cosmetic alignment is important. This technique provides anesthesia to the auricle with the exception of the concha and meatus. After cleansing the ear and surrounding skin with antiseptic solution, anesthetize with buffered lidocaine 1 percent with epinephrine using a long (1.5 inch), small gauge (25 or 27 gauge) needle and injecting along a straight track within the skin covering the mastoid and temporal bone anterior and behind the auricle as shown in the figure. The total dose of buffered lidocaine administered should not exceed 7 mg/kg (0.7 mL/kg) of lidocaine 1 percent. Lidocaine with epinephrine should be avoided when directly infiltrating the ear itself.