Background Post-auricular procedures in aesthetic surgery, including hyaluronic acid filler correction for “lying ears,” otoplasty, and cartilage harvest, traditionally require direct local infiltration. This technique causes significant pain and tissue distortion that may compromise surgical precision. The greater auricular nerve (GAN) provides primary sensory innervation to the post-auricular region and represents an accessible target for regional blockade. This study evaluates the efficacy of ultrasound-guided GAN block for providing anesthesia to the post-auricular region. Methods This prospective, self-controlled, single-blind study enrolled 20 healthy volunteers. Each participant received an ultrasound-guided GAN block on one random side and a sham saline injection on the contralateral control side. Outcomes included sensory mapping with 10-g Semmes–Weinstein monofilament, quantitative pressure pain thresholds using a digital Newton meter at three anatomical points (earlobe, posterior concha, post-auricular sulcus), and visual analog scale (VAS) scores during simulated procedural injections . Block duration was also documented. Results The GAN block produced consistent anesthesia of the earlobe, post-auricular sulcus, and lower two-thirds of the posterior ear while sparing the conchal bowl and upper helix. Pain thresholds on the blocked side reached the maximum measurable force (3.0 N) at all test points in all 20 subjects, significantly exceeding baseline values (p < 0.02). Mean VAS scores during simulated injections were 1.15 ± 0.75 on the blocked side versus 4.1 ± 0.91 on the control side (p < 0.02), representing a significant reduction in perceived pain. Mean block duration was 4.47 ± 0.55 hours. No complications occurred. Conclusions Ultrasound-guided GAN block with minimal anesthetic volume provides profound, reliable post-auricular anesthesia without tissue distortion. This technique significantly ameliorates injection pain at minimal cost, preserves surgical landmarks for precision procedures, and provides extended postoperative analgesia. This pilot study supports the feasibility of the technique and provides a rationale for future patient-based trials. Level of Evidence II This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a>.

Ultrasound-Guided Greater Auricular Nerve Block: A Pilot Study for Pain Management in Post-Auricular Injection

期刊论文
发表日期：

2026年8月3日

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Lehao Wu,
Hu Li,
Ruibo Tian,
Tailing Wang,
Jian Wu,
Yihao Xu

摘要

Background

Post-auricular procedures in aesthetic surgery, including hyaluronic acid filler correction for “lying ears,” otoplasty, and cartilage harvest, traditionally require direct local infiltration. This technique causes significant pain and tissue distortion that may compromise surgical precision. The greater auricular nerve (GAN) provides primary sensory innervation to the post-auricular region and represents an accessible target for regional blockade. This study evaluates the efficacy of ultrasound-guided GAN block for providing anesthesia to the post-auricular region.

Methods

This prospective, self-controlled, single-blind study enrolled 20 healthy volunteers. Each participant received an ultrasound-guided GAN block on one random side and a sham saline injection on the contralateral control side. Outcomes included sensory mapping with 10-g Semmes–Weinstein monofilament, quantitative pressure pain thresholds using a digital Newton meter at three anatomical points (earlobe, posterior concha, post-auricular sulcus), and visual analog scale (VAS) scores during simulated procedural injections . Block duration was also documented.

Results

The GAN block produced consistent anesthesia of the earlobe, post-auricular sulcus, and lower two-thirds of the posterior ear while sparing the conchal bowl and upper helix. Pain thresholds on the blocked side reached the maximum measurable force (3.0 N) at all test points in all 20 subjects, significantly exceeding baseline values (p < 0.02). Mean VAS scores during simulated injections were 1.15 ± 0.75 on the blocked side versus 4.1 ± 0.91 on the control side (p < 0.02), representing a significant reduction in perceived pain. Mean block duration was 4.47 ± 0.55 hours. No complications occurred.

Conclusions

Ultrasound-guided GAN block with minimal anesthetic volume provides profound, reliable post-auricular anesthesia without tissue distortion. This technique significantly ameliorates injection pain at minimal cost, preserves surgical landmarks for precision procedures, and provides extended postoperative analgesia. This pilot study supports the feasibility of the technique and provides a rationale for future patient-based trials.

Level of Evidence II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.