Great auricular nerve blockade using high resolution ultrasound: a volunteer study

Abstract

SummaryThis prospective, observational volunteer study aimed to describe the appearance of the great auricular nerve using ultrasound and its blockade under ultrasound guidance. An in‐plane needle guidance technique was used for blockade of the great auricular nerve with 0.1 ml mepivacaine 1%. Sensory block was evaluated by pinprick testing in comparison with the contralateral area propriae. The great auricular nerve was successfully seen in all volunteers and the tail of the helix, antitragus, lobula and mandibular angle were blocked in all cases whereas the antihelix and concha were never blocked. Ultrasound imaging of the great auricular nerve can be reliably achieved and successful blockade with minimal volumes of local anaesthetic is another example of the benefits of ultrasound‐guided peripheral nerve blocks.

Hypoesthesia of the Cutaneous Branch of Cervical Plexus after Shoulder Arthroscopy under General Anesthesia with Ultrasound Guided-Interscalene Block

“…The lesser occipital nerve arrives from the second, and sometimes the third, cervical nerve. It runs posteriorly along the sternocleidomastoid muscle, perforating the deep fascia near the cranium and ascending behind the auricle to provide the cutaneous supply [13]. The great auricular nerve is the largest sensory branch among the superficial branches of the cervical plexus arising from the C2 and C3 spinal roots.…”

Ultrasound‐guided spinal accessory nerve blockade in the diagnosis and management of trapezius muscle‐related myofascial pain

“…have described a path using the greater auricular nerve as a ‘road map’ for locating the spinal accessory nerve. The cranial and anterior path of the greater auricular nerve passing superficial to the sternocleidomastoid muscle can be traced using surface landmarks [7] or it can be located using ultrasound [8]. The spinal accessory nerve lies 1 cm superior to the greater auricular nerve at the posterior border of the sternocleidomastoid muscle [7].…”

Role of Sonography in Surgical Decision Making for Iatrogenic Spinal Accessory Nerve Injuries

“…Identification of the nerve is facilitated at the level of the SCM by identifying the great auricular nerve, which appears as a 1‐mm oval hypoechoic structure characteristically coursing both deep and superficial to the SCM (Figure 2C). 24 , 26 , 27 The SAN is typically located passing through or deep to the posterior border of the SCM approximately 1 cm superior to the great auricular nerve. Within the posterior cervical triangle, the SAN can be distinguished from the supraclavicular nerves by identifying the distal course of the supraclavicular nerves superficial to the trapezius and clavicle, whereas the SAN passes deep to the upper trapezius.…”