. 9999; 0: 0-0

Comparing two different concentrations of Diphenhydramine vs. Lidocaine for median nerve block in emergency department: a double-blind randomized clinical trial

Shervin Farahmand1, Fariba Yazdanbakhsh2, Shahram Bagheri-Hariri1, Ehsan Aliniagerdroudbari3, Atefeh Abdollahi4, Sepideh Babaniamansour5
1Prehospital Emergency Research Center, Tehran University Of Medical Sciences, Tehran, Iran/ Department Of Emergency Medicine, Imam Khomeini Hospital Complex, Tehran University Of Medical Sciences, Tehran, Iran
2Department of Emergency Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
3Department of Emergency Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4Prehospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
5Department of Emergency Medicine, School of Medicine, Islamic Azad University of Medical Sciences, Tehran, Iran

Aim: This study aimed to compare two different concentrations of Diphenhydramine vs. Lidocaine for median nerve block in terms of providing required anesthesia for repairing soft tissue injuries.
Materials and Methods: This double-blind randomized clinical trial was conducted in Tehran, Iran during 2019. Participants were randomly assigned to three groups. Group A received 3 cc of 0.5% diphenhydramine (n=68), group B received 3 cc of 1% lidocaine (n=68), and group C received 3 cc of 1% diphenhydramine (n=68). Onset of action, duration of anesthesia, pain during injection, and patients’ satisfaction level were evaluated between the groups.
Results: Two hundred two patients with the mean age of 35.09±13.5 years took part in this study (52.5% male). Age (p = 0.879), onset of action (p = 0.251) and duration of anesthesia (p = 0.081) had no significant difference among the 3 groups. The pain during injection between groups A and B (p = 0.001) and between groups B and C (p < 0.0001) had significant difference. Patients in group B had significantly the highest level of satisfaction (p < 0.0001).
Conclusion: In our study, two different concentrations of diphenhydramine had the same onset of action and duration of anesthesia compared to lidocaine. Lidocaine caused lower pain during injection compared to diphenhydramine and the level of satisfaction was higher with lidocaine. Diphenhydramine had no significant difference with different concentrations in term of pain during injection.

Keywords: Hospital emergency service, Diphenhydramine, Lidocaine, Pain Measurement, Median Nerve.


Shervin Farahmand, Fariba Yazdanbakhsh, Shahram Bagheri-Hariri, Ehsan Aliniagerdroudbari, Atefeh Abdollahi, Sepideh Babaniamansour. Comparing two different concentrations of Diphenhydramine vs. Lidocaine for median nerve block in emergency department: a double-blind randomized clinical trial. . 9999; 0: 0-0

Corresponding Author: Sepideh Babaniamansour, Iran


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