Local Anesthetic Maximum Dose Calculator

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Use actual body weight for most patients. For obese patients, consider lean body weight to avoid over-dosing.
kg
Amide agents (lidocaine, bupivacaine, ropivacaine, mepivacaine, levobupivacaine, prilocaine) are metabolised in the liver. Chloroprocaine is an ester metabolised by plasma cholinesterase.
Select the percentage concentration printed on the vial. A 1% solution contains 10 mg/mL.
Epinephrine (adrenaline) reduces systemic absorption, raising both the safe dose ceiling and the duration of action. Avoid in end-arterial regions (fingers, toes, nose, ears, penis).
Maximum safe doseMaximum safe dose
300mg

Weight-based maximum, capped at the published absolute limit.

Maximum volume30mL
Dose limit4.5mg/kg
Concentration10mg/mL
Onset2min
Duration90min
Lipid rescue bolus (20% Intralipid)105mL
Lipid rescue infusion rate17.5mL/min
Lipid rescue max volume840mL
Max dose (mg)300
Max volume (mL)30
Lipid bolus (mL)105

Maximum Lidocaine dose: 300.0 mg / 30.0 mL

  • The maximum safe dose of Lidocaine for this 70.0 kg patient is 300.0 mg, equivalent to 30.0 mL of the 1% solution.
  • Without epinephrine, the dose ceiling is lower. Adding a vasoconstrictor would allow a higher dose and longer duration in appropriate anatomical locations.
  • Lidocaine is an amide-class agent metabolised by the liver. Dose cautiously in patients with hepatic impairment or when multiple amide agents are combined, as toxicity is additive.
  • Expected duration of action is approximately 90 minutes (1.5 hours).
  • If LAST is suspected, give 20% Intralipid 105.0 mL IV over 1 minute as a bolus, then 17.5 mL/min infusion. Have Intralipid available wherever blocks are performed.

Next stepAlways aspirate before injecting to reduce intravascular injection risk. Use incremental dosing with a test dose when feasible, and monitor for early LAST symptoms for at least 30 minutes after injection.

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