31 Anesthesia Techniques Used for Donor and Recipient Areas

Ricardo Mejia

Summary

This chapter will provide the reader with the important practical aspects to consider for effective painless and safe anesthesia in hair transplantation surgery. It focuses on understanding lidocaine limits, epinephrine concentrations, and tumescent lidocaine anesthesia.

Key words

preoperative sedation - field blocks - lidocaine limits - tachyphylaxis - pain management - epinephrine concentrations - buffering - ring blocks

• 1 Davoudi A, Rismanchian M, Akhavan A et al. A brief review on the efficacy of different possible and nonpharmacological techniques in eliminating discomfort of local anesthesia injection during dental procedures.. Anesth Essays Res 2016; 10 (1) 13-16 PubMed

• 2 Blazer MM, Petrozzi R, Harris SY et al. Onset and duration of anesthesia for local anesthetic combinations commonly used in forefoot surgery; surprise results with sequential blocks.. Foot 2015; 25 (2) 75-78 PubMed

• 3 Kouba DJ, LoPiccolo MC, Alam M et al. Guidelines for the use of local anesthesia in office-based dermatologic surgery.. J Am Acad Dermatol 2016; 74 (6) 1201-1219 PubMed

• 4 Best CA, Best AA, Best TJ, Hamilton DA. Buffered lidocaine and bupivacaine mixture: the ideal local anesthetic solution?. Plast Surg (Oakv) 2015; 23 (2) 87-90 PubMed

• 5 Maloney III JM, Lertora JJ, Yarborough J, Millikan LE. Plasma concentrations of lidocaine during hair transplantation.. J Dermatol Surg Oncol 1982; 8 (11) 950-954 PubMed

• 6 Alam M, Ricci D, Havey J, Rademaker A, Witherspoon J, West DP. Safety of peak serum lidocaine concentration after Mohs micrographic surgery: a prospective cohort study.. J Am Acad Dermatol 2010; 63 (1) 87-92 PubMed

• 7 Bromage PR, Pettigrew RT, Crowell DE. Tachyphylaxis in epidural analgesia: I. Augmentation and decay of local anesthesia.. J Clin Pharmacol J New Drugs 1969; 9 (1) 30-38 PubMed

• 8 Na YC, Park R, Jeong HS, Park JH. Epinephrine vasoconstriction effect time in the scalp differs according to injection site and concentration.. Dermatol Surg 2016; 42 (9) 1054-1060 PubMed

• 9 Olkkola KT, Isohanni MH, Hamunen K, Neuvonen PJ. The effect of erythromycin and fluvoxamine on the pharmacokinetics of intravenous lidocaine.. Anesth Analg 2005; 100 (5) 1352-1356 PubMed

• 10 Yang LQ, Yu WF, Cao YF, Gong B, Chang Q, Yang GS. Potential inhibition of cytochrome P450 3A4 by propofol in human primary hepatocytes.. World J Gastroenterol 2003; 9 (9) 1959-1962 PubMed

• 11 Copeland SE, Ladd LA, Gu XQ, Mather LE. The effects of general anesthesia on whole body and regional pharmacokinetics of local anesthetics at toxic doses.. Anesth Analg 2008; 106 (5) 1440-1449 PubMed

• 12 Moisés EC, Duarte LdeB, Cavalli RdeC et al. Pharmacokinetics of lidocaine and its metabolite in peridural anesthesia administered to pregnant women with gestational diabetes mellitus.. Eur J Clin Pharmacol 2008; 64 (12) 1189-1196 PubMed

• 13 Zaiac M, Aguilera S, Zaulyanov-Scanlan L, Caperton C, Chimento S. Virtually painless local anesthesia: diluted lidocaine proves to be superior to buffered lidocaine for subcutaneous infiltration.. J Drugs Dermatol 2012; 11 (10) e39-e42 PubMed

• 14 Morganroth PA, Gelfand JM, Jambusaria A, Margolis DJ, Miller CJ. A randomized, double-blind comparison of the total dose of 1.0% lidocaine with 1:100,000 epinephrine versus 0.5% lidocaine with 1:200,000 epinephrine required for effective local anesthesia during Mohs micrographic surgery for skin cancers.. J Am Acad Dermatol 2009; 60 (3) 444-452 PubMed

• 15 Klein JA, Jeske DR. Estimated maximal safe dosages of tumescent lidocaine.. Anesth Analg 2016; 122 (5) 1350-1359 PubMed

• 16 Elliott VW. Recipient site anesthesia and hemostasis.. Hair Transpl Forum Int 2002; 12 (2) 47-48