General or Local Anesthesia for Erbium Laser Resurfacing?

The need for anesthesia is directly correlated with the aggressiveness of the treatment.  I have used intravenous sedation for aggressive fractionated CO2 laser resurfacing, and have in the past used it for erbium laser resurfacing.  General anesthesia (intubation) for laser resurfacing is probably overkill. 

For a micro-laser peel,  topical anesthesia is sufficient.  In the right patient, an moderately aggressive fractionated CO2 laser treatment can be accomplished with topical anesthesia and nerve blocks.  However, the majority of my patients who wish to have substantial change for facial rhytids opt to have intravenous sedation with nerve blocks.  In addition, resurfacing is frequently combined with other procedures, making the entire set of procedures more anxiety free and less painful.

Only in a rare instance would general anesthesia be required for a full face resurfacing, and highly unlikely to be needed for an erbium laser.  In our practice we use anything from numbing cream, to nerve blocks +/- sedation.  It all depends on the desired goals, laser setting parameters, etc.  It takes knowledge and experience to design optimum resurfacing plan for each individual patient.