Originally Posted by Canada Foot Guy
Alternatives to lidocaine - a patient who needs local anesthesia but is allergic to Lidocaine and all the other "caines". Is Diphenhydramine hydrochloride is a good alternative. Anyone have any experience with it? Any other suggestions?
From my quick look at the research it seems that Diphenhydramine is a viable alternative local anesthetic to Lidocaine for patients who are allergic to “Caines”(Bartfield, Jandreau, & Raccio-Robak, 1998; Bartfield, May-Wheeling, Raccio-Robak, & Lai, 2001; Ernst et al., 1994)
Dire & Hogan state “The duration of local anesthesia for 1% lidocaine was significantly longer and the depth of anesthesia after 30 minutes was significantly higher than that of 1% diphenhydramine. And Diphenhydramine resulted in skin necrosis in one test subject ”.
You may also want to take a look at Benzyl alcohol (BA) with epinephrine as an alternative, as a couple of studies show that BA is superior to diphenhydramine.(Bartfield et al., 2001)
According to Bartfield, Jandreau, & Raccio-Robak (1998) Benzyl alcohol is a better alternative than diphenhydramine as a local anesthetic for lidocaine-allergic patients.(Bartfield et al., 1998)
Have a read of the studies below,
Hope that helps
Bartfield, J. M., Jandreau, S. W., & Raccio-Robak, N. (1998). Randomized Trial of Diphenhydramine Versus Benzyl Alcohol With Epinephrine as an Alternative to Lidocaine Local Anesthesia. Annals of Emergency Medicine, 32(6), 650-654. doi: 10.1016/s0196-0644(98)70062-9
Bartfield, J. M., May-Wheeling, H. E., Raccio-Robak, N., & Lai, S.-Y. (2001). Benzyl alcohol with epinephrine as an alternative to lidocaine with epinephrine. The Journal of Emergency Medicine, 21(4), 375-379. doi: 10.1016/s0736-4679(01)00404-8
Dire, D. J., & Hogan, D. E. (1993). Double-blinded comparison of diphenhydramine versus lidocaine as a local anesthetic. Annals of Emergency Medicine, 22(9), 1419-1422.
Ernst, A. A., Marvez-Valls, E., Mall, G., Patterson, J., Xie†, X., & Weiss, S. J. (1994). 1% Lidocaine Versus 0.5% Diphenhydramine for Local Anesthesia in Minor Laceration Repair. Annals of Emergency Medicine, 23(6), 1328-1332. doi: 10.1016/s0196-0644(94)70360-4