<![CDATA[Introduction: Surgical interventions during pregnancy present a complex clinical dichotomy requiring the balance of maternal physiological stability with fetal safety. Trauma necessitating ear reconstruction typically requires general anesthesia, which carries elevated risks of difficult airway management, aspiration, and potential neurotoxicity in the developing fetus. The "Ring Block" technique offers a regional alternative, yet evidence regarding its safety profile specifically in second-trimester trauma remains limited. Case presentation: We present the case of a 41-year-old multigravida at 14 weeks of gestation (ASA II) presenting with a complex traumatic laceration of the right auricle following a motor vehicle accident. Given the patient’s advanced maternal age and the risks associated with general anesthesia, including hemodynamic fluctuation and teratogenicity concerns, an awake ear reconstruction was planned. We utilized a landmark-based Ear Ring Block using 12 mL of 2% Lidocaine. The procedure achieved complete surgical anesthesia with a V-pattern and inverted V-pattern injection trajectory. Intraoperative monitoring revealed hemodynamic stability with no fluctuations in mean arterial pressure or fetal heart rate abnormalities. The patient reported a visual analog scale score of zero intraoperatively and was discharged 12 hours after surgery without complications. Conclusion: The Ear Ring Block represents a superior anesthetic modality for auricular trauma in pregnant patients. It effectively mitigates the physiological risks of general anesthesia while providing profound analgesia and hemodynamic stability. This technique should be considered a primary anesthetic strategy for auricular reconstruction in the obstetric population.]]>
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