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How much local anesthesia you can give? It depend on the weight of the patient and on if the local anesthesia has epinephrine in it or not.

Hi guys this is ali from medicine made easy how you doing thank you for um checking my youtube channel today there is an important subject we always getting asked about and we always have to use it in our chemical rotation is the local anesthesia maximum dose calculation you know we have multiple local anesthetics to use especially if you need to drain an abscess

Or to suture an incision and um mostly we have the lidocaine which is the xylocaine and the pubic hand which is the marking and we will talk about both of these in this powerpoint so why we need to know the maximum dose because of the risk of toxicity of this local anesthesia and as you know toxicity of local anesthesia will lead to cardiac um cardiotoxicity

And neural toxicity so put in your mind side effects might happen especially cardiovascular and neurology side effects let’s start with the one percent plane lidocaine which is xylocaine or lidocaine without epinephrine the maximum dose of lidocaine without epinephrine is five milligrams per kilogram so we have one percent as an example here in this powerpoint

Slide so if we have a 70 kilogram adult we can inject up to 350 milligram of a plane one percent lidocaine because you know as we said five milligram per kilogram 70 kilogram that means 350 but how can we know how much we give as a ml a cc cubic centimeters or milliliters actually because it’s one percent lidocaine one percent that means every one ml give you

A 10 milligram of course if you give two percent that means every 1 ml give you 20 milligram so let’s stick to the one percent and you can change when you have a different percentage so as we said we can inject up to 350 milligram of a plain one percent lidocaine that means 3 35 ml because every ml give as we said 10 milligrams what about the lidocaine with

Epinephrine as we know adding epinephrine has a lot of um good effects uh one of them is like we can inject more volume and actually and also has a quicker effect and also we’re going to reduce the risk of bleeding there will be advantage of hemostasis so there are three advantages a quicker action uh less for longer time um and also um again we can we can

Inject more volume and also the hemostasis so there are four advantages of using epinephrine with lidocaine but as you know there are some actually contraindications for the use of epinephrine in the end arteries which means like if you are injecting in the nose or in the ear or in the fingers or in the penis so uh it’s not actually um good to add epinephrine

To the local anesthesia because it might end with gangrene necrosis and gangrene because of the vasoconstriction so the maximum dose of one percent lidocaine with epinephrine is seven milligram per kilogram so again if we calculate for a 70 kilogram adult we have we can give up to 490 milligram which is a 49 ml of lidocaine with epinephrine what about the

Pubification which is the marking also pubificating comes with either 0.25 percent which is a quarter percent or 0.5 which is half percent let’s um use the half percent as an example and definitely the 0.25 percent um will give uh uh less uh concentration per ml so definitely we can give more volume of the 0.25 than the 0.5 definitely half the volume 0.5 we

Can give half the volume of the 0.25 um so um yes so let’s let’s come to the um calculation of the cane which is the marking the maximum dose of bibivocane without epinephrine so let’s start with the plane just like what we start with the lidocaine the plain one so without epinephrine is two milligrams per kilogram uh maybe guys you look at some resources that

Says 2.5 milligram per kilogram i choose to put two just to be on the safe side but you can you can actually it’s between two and 2.5 milligram per kilogram and um so far um for a 70 kilogram adult 70 kilogram if we if we give 2 milligram per kilogram as a maximum dose for 70 kilogram adult we can give um up to 140 milligram so 140 milligram that means how many

How many ml because every ml will give 5 milligram the half percent marking or pubic king every one ml will give five milligram so um uh 28 ml 28 ml times 5 is 140 so um 28 ml of one per of a half percent bb vacant without epinephrine is the maximum dose we can give to a 70 kilogram adult and you can change the calculation definitely depending on the weight of

The patient in kilograms and also the percentage of the uh local anesthesia like if you give for example as we said before if we give a 0.25 percent that means we can give double the amount of the half percent uv gain because uh definitely one ml of 0.25 will give only 2.5 milligram per ml so if we need to give 140 milligram that means we can give 56 ml of the

0.25 percent bibipicane to a 70 kilogram adult okay i don’t want to confuse you guys but i’m trying to make it as easy as possible thank you so much and um let’s come to the pubic cane with epinephrine definitely when we add epinephrine the same advantages that when we add it to the lidocaine is that we can inject more volume and also hemostasis quicker action

And longer duration of action so the maximum dose of the pubic hand with epinephrine is a three milligram per kilogram so this is um one of the advantages one of the advantages that we can give more volume so three milligram per kilogram so we can inject up to 210 milligram of the pvp to a 70 kilogram adult because 70 times a 3 is 210 so how many ml 41 uh

Sorry 42 ml why because we said every one ml of 0.5 percent people came give 5 milligram so 42 times 5 is um 210 so 42 ml of half percent ubivocane with epinephrine is the maximum dose we can give to a 70 kilogram adult person i hope guys you enjoy my uh youtube about local anesthesia thank you for uh subscription and supporting my channel if you have any

Comment any question if there is any mistake in the powerpoint slide or my youtubes please let me know in the comments section thanks a lot thank you for watching uh good luck in your career and your study in your exam keep in touch bye now

Transcribed from video

Local Anesthesia maximum dose calculation. How much can you inject. Lidocaine/Bupivacaine. By medicine made easy