A Modified Technique for Auriculotemporal Nerve Blockade When Performing Selective Scalp Nerve Block for Craniotomy

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 cranio- tomy performed under general anes- thesia.1 As described by Pinosky et al in 1996,2 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 vol- umes of local anesthetic ranging from 2 to 5 mL.