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Ultrasound Guided Nerve Block

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Anesthetic Choices and Dosing

Draw up 30cc’s of 1% lidocaine with epinephrine for the block. This will provide 4-6 hours of anesthesia. Longer acting local anesthetics can be used (see table below), but their benefits should be weighed against their higher toxicity and longer onset. In a separate syringe draw up 3cc’s for anesthetizing the skin.

Table 1:  Local anesthetic Doses for Infiltration


Anesthetic

Duration without Epi (min)

Duration with Epi (min)

Maximum Dose without Epi, mg/kg

Maximum Dose with epi, mg/kg

Lidocaine (1%)

30 – 120

60 – 400

4.5

7

Mepivicaine (1%)

30 – 120

30 – 120

4.5

7

Bupivicaine (0.5%)

120-240

240-480

2.5

3.3

 

  1. Dinehart SM. Topical, local and regional anesthesia. In: Wheeland RG, ed. Cutaneous Surgery. Philadelphia: WB Saunders;1994:103.

 



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