Have you run into lidocaine toxicity during hair transplants? How is it mitigated?

The dose of lignocaine is based on patient's weight. It is rare to encounter lignocaine toxicity when doing hair transplant because the requirement is usually small, especially when using a nerve block. If in any case, when lignocaine toxicity is suspected, lipid infusion (intralipid 20%) can be administered. Patient will then be transferred to the nearest hospital for monitoring.

Hello,

Your concern about lidocaine toxicity is understandable but quite rare when performed by experienced professionals. Clinics mitigate this risk by carefully calculating the lidocaine dosage based on your weight and health profile and monitoring you closely during the procedure. Additionally, the total amount used is typically well within safe limits. If this is a concern, discuss it with your surgeon beforehand—they’ll ensure your safety and address any specific questions you have.

Best regards,
Dr. Marco Barusco

Lidocaine toxicity is a rare but important concern during hair transplants. In my experience, cases of lidocaine toxicity are extremely uncommon in hair restoration surgery, but it’s always good to be informed and cautious. During a hair transplant, lidocaine is used to numb the scalp, allowing for a painless procedure. The risk of toxicity arises if too much lidocaine is injected too quickly, potentially affecting the nervous or cardiovascular systems.
Clinics take several precautions to prevent this:
Dose Management: The maximum safe dose of lidocaine with epinephrine (which prolongs the effect of lidocaine and reduces the required amount) is carefully calculated based on your body weight. Most clinics stay well below this limit to ensure safety.
Slow and Controlled Administration: Lidocaine is administered in a slow, controlled manner, allowing it to take effect gradually and minimizing any potential risk of toxicity.
Dilution with Epinephrine: As mentioned, epinephrine is commonly added to the lidocaine solution. This helps constrict blood vessels, slowing the absorption of lidocaine into the bloodstream and reducing the likelihood of toxicity.
Patient Monitoring: During the procedure, clinics monitor your vital signs to ensure everything is progressing smoothly. If any signs of toxicity appear, such as dizziness or ringing in the ears, the staff will be trained to take immediate action.
While the risk is low, discussing your concerns with your surgeon can give you added reassurance. Many patients share your worries, and understanding how safety protocols are followed can help ease anxiety.