Local anesthesia and its considerations in hair transplantation with the F.U.E technique

Introduction. This literature review addresses key aspects of local anesthesia and its application in hair transplantation. Development. Local anesthetics work by reversibly interrupting nerve conduction. They are divided into esters and amides, with amides being the most common in clinical practice due to their stability and safety profile. The action of local anesthetics depends on factors such as their lipid solubility, protein binding, pKa, vasodilation activity and tissue diffusion, they can also be combined with vasoconstrictors to improve their safety profile and reduce bleeding. It is very important to know the properties of lidocaine and bupivacaine, two local anesthetics frequently used in hair transplants, as well as the most common techniques for applying local anesthesia to the scalp, which are ring or field blocks and nerve blocks. Discussion. In hair transplantation, the application of local anesthesia is one of the most important steps to take into account, in order to produce minimal pain or discomfort and to ensure that the patient has a good experience. To avoid side effects and complications, it is important to avoid vascular infiltration of local anesthetics with vasoconstrictors and to consider that in the Follicular Unit Excision (F.U.E.) technique, anesthetizing large areas is required, which may exceed the maximum doses of anesthetics. Conclusion. It is important to perform a good evaluation of the patient to avoid complications, as well as to know the application technique and the medications used to avoid side effects and complications that may arise.