A survey on the use of premedication prior to iodinated and gadolinium-based contrast material administration

The aim of this study was to assess Society of Uroradiology member use of premedication before the intravenous administration of low-osmolality iodinated contrast materials (LOCM) and gadolinium-based contrast materials (GBCM).

Society of Uroradiology members were invited to complete a Web-based survey concerning the use of premedication. The survey included scenarios concerning intravenous LOCM or GBCM injection in which respondents were asked whether they would recommend premedication or withhold contrast material injection. Results for LOCM questions were compared with those for GBCM questions. Question responses for LOCM were also compared with those from a similar Society of Uroradiology survey published in 1995.

Sixty-two of 72 respondents (86%) used standardized premedication regimens. Fifty-nine of 61 described regimens (97%) included oral corticosteroids and 48 (79%) antihistamines. Twenty of 69 respondents (29%) had separate urgent premedication regimens. There was general agreement concerning premedication use; however, responses were inconsistent in patients with severe food or medication allergies, severe symptomatic asthma, or prior mild urticarial reactions. More respondents recommended premedication before LOCM than GBCM administration. More respondents recommended premedication or avoidance of contrast material injection in patients with prior contrast reactions in the current study compared with the 1995 study.

There is frequent agreement among uroradiologists concerning the use of corticosteroid prophylaxis, but there is inconsistency in some clinical situations. The threshold for premedication is often lower for LOCM than GBCM. Since 1995, recommendations for use of premedication have become more widespread.