Objective To evaluate the consumption of opioid and postoperative analgesia of intercostal nerve block （ICNB） and paravertebral block （PVB） for autologuous rib cartilage graft for auricular reconstruction in children with microtia. Methods A total of 120 patients scheduled for autologuous rib cartilage graft for auricular reconstruction were enrolled. According to randomized blocks， patients were allocated into three groups （n=40 in each group）：general anesthesia group （GA group）， ultrasound-guided intercostal nerve block group （ICNB group） and ultrasound-guided PVB group （PVB group）. GA group only received general anesthesia， while ICNB group and PVB group received single-shot nerve block with lidocaine after induction of general anesthesia. All groups were received patient-controlled intravenous analgesia （PCIA） for 48 hours postoperatively. Intraoperative opioid requirement was recorded. Heart rate （HR） and mean arterial pressure （MAP） were recorded at different time points during surgery. Time of the first visual analogue scale （VAS） obtained and duration of postanesthesia care unit （PACU） stay were evaluated. The VAS scores of chest and ear during deep breath and at rest were recorded during 48 hours postoperatively. Opioid consumption and postoperative analgesia-related adverse events were compared among the three groups during 48 hours after surgery. Results Compared with those in GA group， intraoperative fentanyl consumption（P=0.02，P<0.01）， time of the first VAS obtained （P<0.01，P=0.02）， duration of PACU stay （P<0.01，P<0.01） and HR when harvesting the first rib cartilage （P=0.04，P<0.01） were statistically lower in ICNB group and PVB group than those in GA group， but no statistical difference was found between these two groups. There were no statistical differences in VAS scores， opioid consumption and analgesia-related adverse events among the three groups. Conclusion Ultrasound-guided single-shot ICNB and PVB with lidocaine provide similar efficacy of reducing intraoperative opioid consumption， maintaining intraoperative hemodynamic stability and faster awakening， but fail to alleviate postoperative pain.