Pain on administration of non-alkalinised lidocaine for carpal tunnel decompression: A comparison between the Gale and the “advancing wheal” techniques

Abstract

Methods: This study compares two methods of administration of non-alkalinised lidocaine for carpal tunnel decompression in volunteers as well as in patients undergoing carpal tunnel release: The Gale subcutaneous injection technique and another subcutaneous injection technique known as the “advancing wheal” technique. The comparison was done in nine male volunteers and in 20 patients. In the volunteer part of the study, both hands were injected and, hence, each volunteer acted as his own control. In the clinical part of the study, the 20 patients were randomised, with 10 patients receiving the Gale technique and the other 10 receiving the wheal technique. Results: In volunteers, the advancing wheal technique was associated with less pain; but with a longer duration of injection and a higher number of needle pricks when compared with the Gale technique. Eight volunteers preferred the advancing wheal technique because the overall pain experience was less. One volunteer preferred the Gale technique because it took less time to complete the injection procedure. Clinically, the wheal technique also had a significantly lower mean pain score than the Gale technique. Conclusion: It was concluded that the advancing wheal technique is associated with less pain than the Gale technique.

Key Words:

• Carpal tunnel
• injection
• lidocaine
• pain
• technique

Acknowledgements

We would like to acknowledge the group of Medical Students who helped in the data collection of the clinical study: A. S. Hussain, A. S. Al-shaya, G. F. Al-Otaibi, S. E. Shetawe, M. H. Al-Abdely, and H. F. Al-Otaibi. The study was supported by the College of Medicine Research Center, Deanship of Scientific Research, King Saud University, Riyadh, Saudi Arabia. This study was approved by the Ethics Committee at the Medical College of King Saud University.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.