One of the biggest mistakes made in hair transplantation is the overdose of the local anesthetic used. Since Local anesthetics are metabolized in the liver ,overdose may occur in excessive use of these substances. The maximum dose of local anesthetic containing adrenaline which is 3-4.5 mg/kg (maximum 300 mg for a 70 kg adult), and 1.5-2 mg/kg for those without adrenaline. It should not be forgotten that while local anesthesia is given to the borders of the surgical field in hair transplantation operations, adrenaline, tumescent fluid and local anesthetic substance are injected to ventilate the scalp in the transplanted and harvested area. Incorrect and excessive use of these preparations may cause tissue loss in the transplantation and donor areas. Overdose may cause slowing of metabolism due to liver failure, resulting in dysfunction in organs and muscles. The earliest signs of local anesthetic toxicity are restlessness, numbness around the mouth, and lightheadedness. Apart from this, there may be metallic taste, nausea, vomiting and tinnitus. If local anesthetic substance overdose has occurred, nystagmus, tremor, convulsions and even respiratory arrest may be observed.
In addition, the use of adrenaline-containing preparations may cause cardiac side effects due to adrenaline. It should also be noted that adrenaline interacts with many drugs. The biggest side effects of these interactions are that they can cause severe hypertension and even cardiac arrest.
As a result, after determing to do hair transplantation, it is the most important to note that the clinic in where hair transplantation will be done must be fully equipped and under the control of a doctor.