TABLE 3

Commonly Used Local Anesthetic Agents for Nerve Block or Infiltration: Doses, Duration, and Calculations

Local AnestheticMaximum Dose With Epinephrine,a mg/kgMaximum Dose Without Epinephrine, mg/kgDuration of Action,b min
MedicalDentalMedicalDental
Esters
 Procaine10.067660–90
 Chloroprocaine20.012151230–60
 Tetracaine1.5111180–600
Amides
 Lidocaine7.04.444.490–200
 Mepivacaine7.04.454.4120–240
 Bupivacaine3.01.32.51.3180–600
 Levobupivacainec3.0222180–600
 Ropivacaine3.0222180–600
 Articained7760–230
  • Maximum recommended doses and durations of action are shown. Note that lower doses should be used in very vascular areas.

  • a These are maximum doses of local anesthetics combined with epinephrine; lower doses are recommended when used without epinephrine. Doses of amides should be decreased by 30% in infants younger than 6 mo. When lidocaine is being administered intravascularly (eg, during intravenous regional anesthesia), the dose should be decreased to 3 to 5 mg/kg; long-acting local anesthetic agents should not be used for intravenous regional anesthesia.

  • b Duration of action is dependent on concentration, total dose, and site of administration; use of epinephrine; and the patient’s age.

  • c Levobupivacaine is not available in the United States.

  • d Use in pediatric patients under 4 years of age is not recommended.