E1027. Safety and Feasibility of Diphenhydramine as an Alternative Local Anesthetic Agent for Radiology Procedures
Authors
Lekui Xiao;
Mayo Clinic Rochester
Sagar Wagle;
Mayo Clinic Rochester
John Schmitz;
Mayo Clinic Rochester
Gina Hesley;
Mayo Clinic Rochester
Ahmad Parvinian;
Mayo Clinic Rochester
Nathan Brinkman;
Mayo Clinic Rochester
Michael Moynagh;
Mayo Clinic Rochester
Objective:
To retrospectively evaluate the safety and feasibility of subcutaneous diphenhydramine as an alternative local anesthetic for radiology procedures.
Materials and Methods:
Between January 2000 and April 2021, 84 image-guided procedures were performed in 81 adult patients (mean age: 61 years, 86% female) using 1% diphenhydramine as a local anesthetic. Indications were history of severe allergy to caine class local anesthetics in 76 (90%) patients and recent administration of bupivacaine liposomal injectable suspension in eight (10%) patients; 12/81 (15%) patients received concomitant moderate sedation. Patient characteristics, procedural techniques and clinical outcomes were reviewed. Early and delayed (30-day) complications were classified and gradated using the Clavien-Dindo system.
Results:
Percutaneous biopsy was the most commonly performed procedure (57/84, 67%). 59 (70%) of the procedures were ultrasound-guided and 34 (40%) involved the breast. All procedures were technically successful. There were three (3.6%) minor complications. A single patient required hospital admission for post kidney biopsy related hematuria. The two other minor complications were related to post procedural pain. There were no episodes of skin necrosis or allergic reaction.
Conclusion:
Injectable diphenhydramine is a safe and useful local anesthetic alternative in patients with caine class contraindications undergoing radiology procedures.
