Efficacy of Local Anesthesia in the Face and Scalp

A Prospective Trial

Tyler Safran, MD; Dino Zammit, MD; Jonathan Kanevsky, MD, FRCSC; Manish Khanna, MD, FRCPC


Plast Reconstr Surg Glob Open. 2019;7(5):e2243 

In This Article


This study is not without its limitations: first, the small sample size was unable to elicit a more precise and significant topographic map of particular areas of anesthetic difficulty. Instead, the study simply categorized the patients into upper face, lower face, and ear. This specification could allow the surgeon to better understand specific nerve distributions that may be less susceptible to infiltrative anesthesia and would rather opt for a regional block. Second, each patient has different patient-specific factors that could have impeded the result. For example, some patients when feeling pressurized, may have opted for more anesthesia saying that it was in fact painful. Lastly, certain patient comorbidities, such as poorly controlled diabetes mellitus and smoking status, could have had an influence on the result.[20] The mean age of the patients was 50 years or older, which has been shown in prior literature to have a negative effect on sensation and nervous distribution.[20] These patients and factors could have conflicted some of the stats; however, the sheer statistical significance of the results is quite favorable for the result obtained nonetheless. Finally, another nondocumented factor was patients having red hair. This phenomenon has been shown in trials compared with non-redheads, where they required significantly more anesthesia (both inhalational and local) for the same clinical effect.[21,22]