title: 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.
  
  
  CONCLUSIONS
  It was concluded that the advancing wheal technique is associated with less pain than the Gale technique.
authors.affiliation: a Division of Plastic Surgery, King Saud University , Riyadh, Saudi Arabia.
authors.forename: Abdullah E
authors.initials: AE
authors.lastname: Kattan
authors.affiliation: a Division of Plastic Surgery, King Saud University , Riyadh, Saudi Arabia.
authors.forename: Feras
authors.initials: F
authors.lastname: Al-Shomer
authors.affiliation: a Division of Plastic Surgery, King Saud University , Riyadh, Saudi Arabia.
authors.forename: Albaraa
authors.initials: A
authors.lastname: Al-Jerian
authors.affiliation: a Division of Plastic Surgery, King Saud University , Riyadh, Saudi Arabia.
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Al-Qattan
mesh_terms: D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects / Q000379:methods*; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D057240:Patient Preference; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine
keywords: Carpal tunnel; injection; lidocaine; pain; technique