From the Research
Redheads do not require more sedation and analgesics compared to people with other hair colors, as the current evidence does not support a significant difference in anesthetic and analgesic management based on self-reported red-hair phenotype. The study by 1 found no significant differences in the relative risk of intraoperative awareness, anesthetic management, recovery times, or postoperative pain between red-haired patients and control patients. This suggests that perioperative anesthetic and analgesic management should not be altered based on self-reported red-hair phenotype.
Some studies have suggested that redheads may have increased resistance to local anesthetics like lidocaine and may require more general anesthesia, but these findings are not consistent across all studies. For example, the study by 1 found that the relationship between pharmacokinetically stable volatile anesthetic concentrations and bispectral index values differed significantly between red-haired patients and controls, but without clinical implications.
The genetic variation in the melanocortin-1 receptor (MC1R) gene, which is responsible for red hair pigmentation, may affect how the body processes pain signals and responds to certain medications. However, the clinical implications of this phenomenon in red-haired patients undergoing surgery are currently unknown, and more research is needed to fully understand the relationship between red hair and anesthetic requirements.
In terms of specific medications, some studies have suggested that redheads may require higher doses of certain medications, such as propofol, sevoflurane, or opioid analgesics. However, these findings are not consistent across all studies, and more research is needed to determine the optimal dosing for redheaded patients.
Overall, the current evidence does not support a significant difference in anesthetic and analgesic management based on self-reported red-hair phenotype, and anesthesiologists and pain management specialists should not alter their management based on hair color alone. Instead, they should use their clinical judgment and consider individual patient factors, such as medical history and current health status, when determining the optimal anesthetic and analgesic plan.
Some key points to consider when managing redheaded patients include:
- There is no significant difference in the relative risk of intraoperative awareness between red-haired patients and control patients 1
- Anesthetic management should not be altered based on self-reported red-hair phenotype 1
- The relationship between pharmacokinetically stable volatile anesthetic concentrations and bispectral index values may differ between red-haired patients and controls, but without clinical implications 1
- More research is needed to fully understand the relationship between red hair and anesthetic requirements.
It is essential to prioritize morbidity, mortality, and quality of life when managing patients, regardless of their hair color. The most recent and highest quality study, 1, should be prioritized when making decisions about anesthetic and analgesic management for redheaded patients.