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Delaware Health Alert Network #169

January 23, 2009 9:03 am

Health Advisory

Delaware’s Division of Public Health would like to advise health care providers of potential life-threatening adverse effects presented by improper use of topical anesthetics, such as lidocaine gel, prior to mammography. This concern is due in part to reports of deaths following similar use of topical anesthetics by women preparing for laser hair removal procedures, according to the U.S. Food and Drug Administration (FDA).

Improper use may include (but is not limited to):

  • Applying too much of the topical anesthetic;
  • Applying to a large area of skin;
  • Applying to irritated or broken skin;
  • Covering the skin with a wrap or using a heating pad after applying the topical anesthetic.

Improper use of topical anesthetics can lead to excessive absorption of the drug into the bloodstream and may cause life-threatening side effects such as irregular heartbeat, seizures, breathing difficulties, coma and even death.

The FDA’s message for patients regarding use of a topical anesthetic prior to mammography is as follows:

  • Do not use anesthetic unless you first consult your health care professional;
  • If recommended, use a product containing the lowest amount of anesthetic drug possible;
  • Apply only the amount recommended by your health care professional;
  • Do not apply to broken or irritated skin;
  • Do not wrap or cover the skin with any type of material or dressing, as it may increase the risk of potential life-threatening side effects.

The FDA’s message for health care professionals who are considering recommending a topical anesthetic prior to mammography is to discuss the following with your patients:

  • The potential side effects of topical anesthetics;
  • How to detect any side effects of topical anesthetics;
  • How to lower the chance of life-threatening side effects from topical anesthetics;
  • What to do if side effects from a topical anesthetic occur.

To date, no cases of adverse effects associated with the use of topical anesthetic prior to mammography procedures have been reported in Delaware.

For more information about this issue, see the FDA public health advisory at www.fda.gov/cder/drug/advisory/topical_anesthetics2009.htm. Consumers and healthcare professionals can report adverse events to the FDA's MedWatch program at 800-FDA-1088, by mail at MedWatch, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787, or online at www.fda.gov/medwatch/report.htm.

For questions regarding this advisory, contact the Health Systems Protection Section, Delaware Division of Public Health, at (302) 744-4546.

Categories of Health Alert messages:

  • Health Alert: Conveys the highest level of importance; warrants immediate action or attention.
  • Health Advisory: Provides important information for a specific incident or situation; may not require immediate action.
  • Health Update: Provides updated information regarding an incident or situation; unlikely to require immediate action.
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