Microprocessor-controlled local anesthesia versus the conventional syringe technique in hair transplantation.

[BACKGROUND] Local anesthesia by the traditional injection technique is central to optimizing patient comfort during hair transplant procedures. However, even when carefully and properly performed, some patients still describe their treatment sessions as painful.

[OBJECTIVE] To determine if patients undergoing hair transplantation experience less pain and discomfort when their local anesthesia is performed with the Wand (as of spring 2001, the Wand has been renamed "CompuMed- Featuring the Wand Handpiece"), a microprocessor pump that precisely controls the infusion rate and pressure of local anesthetic solution.

[METHODS] We used combined retrospective studies and a prospective blinded study of men and women who received hair transplantation treatments between January 1999 and March 2001 at our private outpatient clinics in the United States. A total of 101 patients compared their experiences during their hair transplant sessions performed by us before and after we started using the Wand. Thirty-nine patients compared their experiences during treatments done by 32 other medical groups and when we used the Wand. In addition, 88 patients compared the Wand to injection while blinded to technique. The outcomes were measured with patient pain rating questionnaires using the Wong-Baker Faces Pain Rating Scale (0, no pain-5, severe pain).

[RESULTS] Patients in all three study groups reported that anesthesia with the Wand was less painful. Wand anesthesia was overwhelmingly (68%) described as associated with none (0) or very little (1) pain. Surprisingly, Wand anesthesia was associated with superior comfort not only during the administration of anesthesia (P =.005), but throughout the treatment session and during the first 48 postoperative hours.

[CONCLUSION] Microprocessor-controlled local anesthesia with the Wand is superior to traditional injection in consistently producing comfortable hair transplant treatments.