Local Anesthetic Dosing




Table 2


 General recommendations for average volumes of local anesthetic for specific blocks are found in Table 1. In all cases one must never exceed  the  recommended toxic limits of local anesthetic (Table 2), which should be calculated in advance and must also take into account any addition local anesthetic dose administered to the patient by the anesthesiologist or surgeon . Local anesthetic systemic toxicity is a rare event during peripheral nerve blockade but must be assiduously avoided.

Table 1

Area of block
Suggested  
volume (mL/kg)
Postoperative  
analgesic dose
Anesthetic dose
Max dose
(mL)
Above umbilicus
0.2–0.4
0.2% Ropivacaine or
0.25%  bupivacaine
0.35% Ropivacaine or
0.375% bupivacaine
30
Below
umbilicus
0.3–0.5
0.2% Ropivacaine or
0.25%  bupivacaine
0.35% Ropivacaine or
0.375% bupivacaine
40
Compartment block (TAP,
quadratus lumborum,
paravertebral)
0.25
0.2% Ropivacaine or
0.25%  bupivacaine
Surgical anesthetic dose
cannot be obtained (not
applicable)
40








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