# anesthetic question

#### cotinara

##### Senior Member
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7+ Year Member
im exhausted and can't think this one thru. any help please? thanks

if i gave 30 ml of 2% lidocaine with 1:100,000 epinephrine how many mg is that?

#### lotexigeus

##### Master Member
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7+ Year Member
im exhausted and can't think this one thru. any help please? thanks

if i gave 30 ml of 2% lidocaine with 1:100,000 epinephrine how many mg is that?
2% solution = 2g per 100ml, or 2000mg per 100ml, or 20mg/ml.

20mg x 30ml = 600mg lidocaine.

1:100,000 epi = .01mg/ml

.01mg x 30 = 0.3mg epi.

#### panino

7+ Year Member
speaking of which, does anyone have any tips on giving LA?

#### Anatomy Fanatic

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2% solution = 2g per 100ml, or 2000mg per

1:100,000 epi = .01mg/ml

.01mg x 30 = 0.3mg epi.
Your epi dose is way low.

1:100K epi = .018mg (almost twice as high as your estimate)

.018mg*30=0.54mg epi.

And OP, that dose is way past the max dose for LA and for epi.

#### Anatomy Fanatic

10+ Year Member
5+ Year Member
speaking of which, does anyone have any tips on giving LA?
Find a horizontal landmark, a vertical landmark, make a "crosshair" from your landmarks, advance the needle gently but with some firmness to the correct depth (usually until you contact bone), aspirate, inject slowly and steadily.

Once you do it a few times I'm sure it won't be any big deal at all.

#### lotexigeus

##### Master Member
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7+ Year Member
Your epi dose is way low.

1:100K epi = .018mg (almost twice as high as your estimate)

.018mg*30=0.54mg epi.

And OP, that dose is way past the max dose for LA and for epi.
um, no. You're thinking 30 carpules, not 30ml. Big difference.

#### OceanDMD

##### Rather be fishing
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speaking of which, does anyone have any tips on giving LA?

If I told you, I'd have to kill you. Good injections, painless injections, are one of the best internal marketing techniques in the business. And trust me, you will get on a roll with IAs (Im on a 3 month roll right now) where you dont miss. And then you have the week of hell. The biggest frustration I have, in all of the daily bullsh!t I deal with is when someone isnt numb. Its amazing how simple it is to piss you off. But, when I have scheduled #18 MO, 30 minutes, and i always inject and wait 10 minutes ( second molars dont work well with septo, you have to block),you sit down, lips numb, cut, ouch....Im pissed. . As far as painless injections, find a mentor and good topical. There are tricks, and its not about shaking the lip.

#### OceanDMD

##### Rather be fishing
10+ Year Member
7+ Year Member
Find a horizontal landmark, a vertical landmark, make a "crosshair" from your landmarks, advance the needle gently but with some firmness to the correct depth (usually until you contact bone), aspirate, inject slowly and steadily.

Once you do it a few times I'm sure it won't be any big deal at all.

Contacting bone is not critical, and often when you do thats when the patient jumps. Tell me, do you feel the need to use the 27 gauge long needle to give an IA ?

#### Anatomy Fanatic

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um, no. You're thinking 30 carpules, not 30ml. Big difference.
Hahaha whoops! You're right I was thinking carps not mL!

#### Anatomy Fanatic

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Contacting bone is not critical, and often when you do thats when the patient jumps. Tell me, do you feel the need to use the 27 gauge long needle to give an IA ?
Since I'm still fairly new to the anesthetic delivery business, I have only really used 27 longs. I would definitely like to get to the point where I could feel as comfortable injecting with a short needle so that I wouldn't contact bone.

I'm sure in the future when I'm relying less on bony contact to verify that I'm near the nerves I'll prefer the shorter needles since it will minimize any possible patient discomfort from jabbing the bone.

#### aphistis

Moderator Emeritus
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15+ Year Member
speaking of which, does anyone have any tips on giving LA?
Try to put it next to the nerve.

#### goosestuff

##### 10-4, Chicken Feed, 10-4
10+ Year Member
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um, no. You're thinking 30 carpules, not 30ml. Big difference.
30mL of 2% Lido w/ 1:100k epi?!! That's over 16 carpules - you don't think that's over the max dosage of either lido or epi?!

#### lotexigeus

##### Master Member
10+ Year Member
7+ Year Member
30mL of 2% Lido w/ 1:100k epi?!! That's over 16 carpules - you don't think that's over the max dosage of either lido or epi?!