Pain perception of a new Ahmad-Humayun solution for local anesthesia in hair transplantation: One step ahead

Local anesthetic is one of the major ways to obtain satisfactory anesthesia in majority of plastic surgical procedures.

To compare the effect on pain while injecting buffered vs nonbuffered local anesthetic.

The single-blind, split-scalp study was conducted in 25 patients undergoing first hair transplant surgery after informed consent and ethics committee approval using two solutions. Solution A was composed of normal saline (200 mL), 2% lidocaine (40 mL), 1 mL of epinephrine 1:1000, and triamcinolone acetate (40 mg). Solution B was composed of normal saline (200 mL), 2% lidocaine (40 mL), 1 mL of epinephrine 1:1000, triamcinolone acetate (40 mg), and 8.4% soda bicarbonate (5 mL). A 3-mL syringe with 30-G needle was used. On one side of the scalp, solution A was used and solution B on the other side. The pain response was recorded using Wong-Baker Faces Pain Scale corresponding to 0-10 scale. The data were analyzed statistically. No preoperative analgesic was used in any patient. The injections were administered by the 2nd author.

A total of 25 patients were included in the study. The mean age of the patients was 33.4 years (range; 28 to 41 years). The average pain score was 4.96 (range, 3-7) with solution A whereas 3.28 (range, 2-6) using the solution B (P < .05). Eleven of the patients (44%) were smokers. The average pain score in smokers was 5.82 with solution A and 3.73 with solution B. The pain score in nonsmokers was 4.29 with solution A and 2.93 with solution B (P < .05).