Reduction in pain associated with open carpal tunnel decompression

Patients treated by open carpal tunnel decompression under local anaestheti c experience significant pain with the introduction of local anaesthetic be fore operation. A prospective double-blind randomized placebo controlled tr ial was carried out to assess whether this pain could be reduced with the p re-application of a topical lignocaine-prilocaine anaesthetic cream. Ninete en patients undergoing simultaneous bilateral operations were studied. Pain , measured with a visual analogue scale, was significantly reduced on the s ides treated with anaesthetic cream. On a four point verbal scale the ratin g on the placebo side was "moderate' or "severe", compared to "mild" on the anaesthetic cream side. The reduction in pain was greater in women, possib ly due to a relatively thinner dermis, There were no adverse effects.