Benadryl as local?

[deleted162650]

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I just finished my ER rotation as a PGY-1. Last week we had a pt. who needed a CVL. The guy says he's allergic to novocaine (not real sure on the details of the reaction as this was another resident's patient, but it's a small ED so I was kinda following in the periphery). Instead of trying lido or another amide, the attending says to use subq benadryl.😱 Sounded like black magic to me, but low and behold 2cc benadryl at the insertion site, and the guy didn't even flinch for the right-IJ. Apparantly benadryl has some Na-channel blocking properties? Anyone else heard of this or tried it?

 

[militarymd]

I just finished my ER rotation as a PGY-1. Last week we had a pt. who needed a CVL. The guy says he's allergic to novocaine (not real sure on the details of the reaction as this was another resident's patient, but it's a small ED so I was kinda following in the periphery). Instead of trying lido or another amide, the attending says to use subq benadryl.😱 Sounded like black magic to me, but low and behold 2cc benadryl at the insertion site, and the guy didn't even flinch for the right-IJ. Apparantly benadryl has some Na-channel blocking properties? Anyone else heard of this or tried it?

see "random google search"

http://www.pfizer.com/files/products/uspi_benadryl.pdf

 

[jwk]

NS works as well.

 

[danzman]

I have heard of people chewing benadryl before getting a tongue piercing.

 

[deleted87051]

A couple years ago I had a very itchy mosquito bite on my hand. I injected a small wheal of benadryl into it. That spot stayed numb for 3-4 months.

 

[Matty44]

Via Pfizer...
"Use as a Local Anesthetic:
Because of the risk of local necrosis, this drug should not be used as a local anesthetic."

Anyone know the dosages that would presumably lead to said necrosis?

 

[psychbender]

Covered this in a Wilderness Med rotation back in med school. We were discussing the various alternative uses for meds, and how to get the most benefit with the least number of drugs. We actually got to try it during some of our procedure labs (minor blocks, dental blocks, etc), and one guy did chew a tablet, and rub it along his gum line. He said it tasted horrible, but he was certainly numb. I think I'll stick with the lidocaine, though.

 

[Coastie]

zofran has been shown to have greater local anesthetic properties than lidocaine. In a RCT from India, it showed the greatest reduction in propofol induced pain on injection.

 

[fakin' the funk]

A couple years ago I had a very itchy mosquito bite on my hand. I injected a small wheal of benadryl into it. That spot stayed numb for 3-4 months.

Benadryl: takes care of your itch, AND MORE!

 

[Fastrach]

Or you could have just tried some Demerol... god knows they have enough of that crap floating around in the ED.