The WAND local anesthetic delivery system: a more pleasant experience for anal anesthesia.
OBJECTIVE
The WAND is a computer-controlled local anesthetic delivery system. Its use has been proven to be more comfortable for dental patients. The purpose of this study is to explore its applicability to anal procedures. Our hypothesis is that the WAND will provide greater comfort during anesthesia delivery while achieving the same anesthetic effect as traditional syringe technique.


METHODS
Twenty patients with painless anal pathology were randomized to receive anal anesthesia using either the WAND or traditional syringe technique to a randomly selected half of the anoderm (right or left). The opposite side was then anesthetized by the alternate method, allowing patients to act as their own control. Objective and subjective pain scores were obtained from the patient after each mode of delivery. An independent observer interpreted the patient's tolerance by giving a subjective pain score. The volume of anesthetic used was recorded. Adequacy of anesthesia was tested by a pinch test.


RESULTS
Sixteen (80 percent) of the 20 patients preferred the use of the WAND. Objective and subjective pain scores per the patients and subjective pain scores per the observer were significantly lower for the WAND than for traditional syringe technique (P < 0.05). The mean volume of local anesthetic used with the WAND was 1.7 ml compared with 3.2 ml for traditional syringe technique (P < 0.005). Anesthesia achieved with the WAND was as good as that achieved with traditional syringe technique when the pinch test was used.


CONCLUSIONS
The WAND is as effective as the traditional syringe technique in the delivery of anal anesthesia while providing a more comfortable experience for the patient.
Tan
P Y
PY
Division of Colon and Rectal Surgery, Keck School of Medicine, University of Southern California, Los Angeles 90033, USA.
Vukasin
P
P
Chin
I D
ID
Ciona
C J
CJ
Ortega
A E
AE
Anthone
G J
GJ
Corman
M L
ML
Beart
R W
RW
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology*; D000772:Anesthesia, Local / Q000295:instrumentation / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D001004:Anus Diseases / Q000601:surgery; D004867:Equipment Design; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control*; D013594:Syringes
D000779:Anesthetics, Local; D008012:Lidocaine