Efficacy of Ultrasound-guided Greater Auricular Nerve Block in Preventing Postoperative Emergence Agitation in Pediatric Patients Undergoing Microscopic Middle Ear Surgery.

Inclusion Criteria: * Age between 5 and 14 years (preschool to early school age group at highest risk for EA). * ASA physical status I or II. * Scheduled for elective microscopic middle ear surgery under general anesthesia (e.g., tympanoplasty, myringoplasty). * Ability to comply with FLACC and PAED scoring during postoperative period. * Informed consent obtained from a parent or legal guardian. Exclusion Criteria: * Known neurological, developmental, or psychiatric disorders (e.g., autism, ADHD, seizure disorder). * Known hypersensitivity to amide local anesthetics (e.g., lidocaine, bupivacaine). * Skin infection, hematoma, or trauma at or near the proposed block site. * Non-elective (emergency) or combined surgeries. * Inability to assess pain or agitation due to hearing loss, or communication impairment. * Parental or legal guardian refusal to participate.