Current hair transplantation techniques require a reliable anesthesia for long periods of time (2 h or more). They demand hemostasis of extended surfaces on wide-awake patients. A combination of anesthetic agents and local vasoconstrictors is needed. We present customary technical characteristics of these procedures as local nerve blocks (supratrochlear nerve, supraorbital nerve, zygomaticotemporal nerve, auriculotemporal nerve, retroauricular nerve, lesser occipital nerve, great occipital nerve) and tumescent field anesthesia. The ordinary drug combinations for premedication and procedure are presented. Special emphasis is done to discuss recommendations to cope with undesirable events that may arise during anesthesia (vasovagal syncope, anesthetic toxicity, anaphylactic and allergic reactions).
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