Patient in position of comfort allowing access to posterior head and neck. (laying prone or sitting with head down in arms)
Identify Greater<unk>  Nerve (GON).
May be palpated 1.5-2.5 cm inferior to<unk>  protuberance and ~1.5-2 cm lateral to midline
Alternatively, may be ultrasound guided - look for<unk>  artery in medial third of the line from<unk>  tubercle to mastoid process
GON will be located medial to artery.
Cleanse skin with betadine or chlorhexidine and allow to dry
Insert needle over nerve at 90 degrees to skin until hit bone, then withdraw slightly
If using ultrasound, insert needle at 45 degrees to skin and advance toward nerve under direct ultrasound guidance
Aspirate to ensure not in vessel.
Inject ~1-3 mL of local anesthetic. (may inject small amount medial and lateral to nerve to ensure adequate block)
Repeat on contralateral side, if indicated.
May be palpated 1.5-2.5 cm inferior to<unk>  protuberance and ~1.5-2 cm lateral to midline
Alternatively, may be ultrasound guided - look for<unk>  artery in medial third of the line from<unk>  tubercle to mastoid process
GON will be located medial to artery.
GON will be located medial to artery.
If using ultrasound, insert needle at 45 degrees to skin and advance toward nerve under direct ultrasound guidance
1% soln contains 10 mg/ml
2% soln contains 20 mg/ml
0.5% soln contains 5 mg/ml
May cause cardiac arrest if injected intravascularly
Do not buffer with bicarbonate
Nerve Block: Occipital
Nerve Block: Supraorbital
Nerve Block: Penile
Nerve Block: Infraorbital
Nerve Block: Median
Nerve block: Auricular
Nerve block: Lingual
Nerve Block: Femoral