as for example lidocaine mepivacaine or bupivacaine one preferred agent is a long duration mepivacaine 5 solution syringe 48 is also a 5 cc syringe containing a long acting depot form of a synthetic corticosteroid ester suitable corticosteroids are those which possess high anti inflammatory relative potencies such as for example prednisolone methyl prednisolone triamcinolone and dexamethasone marketed under the trade names hydeltrasol hydelta t b a depo medrol medrol acetate aristocort diacetate and decadron l a one preferred corticosteroid is methyl prednisolone administered at a dosage range of approximately 1 to 2 milligrams per kilogram of body weight of the patient preferably at 1 4 to 1 6 milligrams per kilogram per injection following insertion of the cannula and attachment of multi way valve syringe adapter 44 and syringes 46 and 48 the lever on the valve is set to permit introduction of the long acting anesthetic from syringe 46 into the injection site after supplying sufficient local anesthetic into the carpal tunnel the lever is then moved to permit introduction of the corticosteroid dosage from syringe 48 into the carpal tunnel after supplying the corticosteroid the cannula is withdrawn the needle guide is removed and the forearm is removed from the armboard in conformity with sterile technique it is also desirable to apply a topical antibiotic and bandage to the injection site in some instances it may also be desirable to apply a volar splint to immobilize the hand and forearm for an eight to twelve hour period before resuming normal activities with the afflicted extremity the procedure may also be repeated on the opposite extremity where bi lateral symptomatology is present fig4 shows a cross sectional schematic view of the apparatus shown in fig3 taken along the lines 4a 4b.