Local anesthetic question

[waterbottle10]

Hi . I have some questions regarding local anesthetics. How long do you guys wait before deciding to redose near max dose? (Eg give 400 mg of lidocaine to 100kg man. When would you be ok to give another dose? Do you base it on elimination half life?

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[leaverus]

what are you even talking about - for nerve blocks?? I don't think I've ever used 400mg lidocaine for anything. for pnb I don't generally repeat blocks although I have on occasion if it's been a few hours. I think this is just one of those clinical judgment situations as i'm not aware of any data on repeat doses of LA; with U/S I think most of us are using low enough volume these days that it doesn't become too much of a concern though

 

[deleted162650]

what are you even talking about - for nerve blocks?? I don't think I've ever used 400mg lidocaine for anything. for pnb I don't generally repeat blocks although I have on occasion if it's been a few hours. I think this is just one of those clinical judgment situations as i'm not aware of any data on repeat doses of LA; with U/S I think most of us are using low enough volume these days that it doesn't become too much of a concern though

You've never given 20mL of 2% for a surgical block or to load an epidural for section?? Really??

 

[leaverus]

You've never given 20mL of 2% for a surgical block or to load an epidural for section?? Really??

you're right - forgot about csections. but for surgical pnb, I've never used lido.

 

[Wiscoblue]

I use 20 ml of 1.5% lido with epi for sections.


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[Robotic Wis-Hipple]

I don't encounter many 60kg sections though either.....

 

[epidural man]

Hi . I have some questions regarding local anesthetics. How long do you guys wait before deciding to redose near max dose? (Eg give 400 mg of lidocaine to 100kg man. When would you be ok to give another dose? Do you base it on elimination half life?

Great question really. I run into this all the time.

I base it on feeling lucky or not feeling lucky. There probably is a much better way to decide however.