A modified technique for auriculotemporal nerve blockade when performing selective scalp nerve block for craniotomy

摘要

Selective scalp nerve block is a technique which has been increasingly used as a surgical anesthetic before awake craniotomy and to decrease analgesic requirements after craniotomy performed under general anesthesia. As described by Pinosky et al in 1996, 6 nerves (4 branches of the trigeminal nerve and the anterior and posterior rami of C2) are identified by landmarks on each side of the cranium (supratrochlear, supraorbital, zygomati-cotemporal, auriculotemporal, lesser occipital, and greater occipital nerves) and subsequently infiltrated with volumes of local anesthetic ranging from 2 to 5mL. A seemingly rare complication of auriculotemporal nerve blockade is inadvertent blockade of the adjacent facial nerve.