local lido with and without epi

Q: Local lidocaine administration with epinephrine requires? (select one)

A) higher than usual dose

B) lower than usual dose

Answer: A

1% lidocaine is usually used for procedures under local anesthesia. It can be administrated either with or without epinephrine. The maximum allowable dose is 4 to 5 mg/kg without epinephrine. If epinephrine is added, the maximum allowable dose can be increased to 5 to 7 mg/kg. This is due to the fact local epi. can induce some vasoconstriction which requires a higher than usual dose of lidocaine.

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References:

1. McCreight A, Stephan M. Local and regional anesthesia. In: Textbook of Pediatric Emergency Procedures, 2nd edition, King C, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2008.

2. McGee DL. Anesthetic and analgesic technique. In: Roberts and Hedges Clinical Procedures in Emergency Medicine, 5th edition, Roberts JR, Hedges JR (Eds), Saunders Elsevier, Philadelphia 2010.