Place patient in a seated or supine position, with forearm in supination and wrist slightly extended

Identify point medial to the palmaris longus tendon or midway between the palmaris longus and flexor carpi ulnaris tendons

Insert a 25-gauge needle 1 cm proximal to the most distal wrist crease

Direct the needle in a 45-degree angle; slide distally until needle end lies under midpoint of the retinaculum

Give as a slow bolus injection; if patient has pain or paresthesias, stop the injection and redirect the needle medially

Advise patient to actively move his or her fingers for several minutes to allow even distribution of the solution