8/12/2019 MRD for LA Calculations.oct.2013

1/6

LA (local anesthesia) Maximum Recommended Dose based on Weight

Calculations based on:

A healthyperson weighing 150 lbs.

Using a 1.8 ml standard cartridge of anesthesia

Concentration of LA in 1.8 solutions varies b tpe of anesthesia:

1! "! #! $!

%o Calculate dose of anesthesia per cartridge: &ultipl the percentage of anesthesia times the cartridge amount

o 1! ' 1.8 ( 18 mg

o "! ' 1.8 ( #) mg

o #! ' 1.8 ( 5$ mg

o $! ' 1.8 ( *" mg

Maximum epinephrine is .2 mg per appointment healthy and .0 i! compromised

1:50+000 ( 0.0" mg,ml

1:100+000 ( 0.01 mg,ml

1:"00+000 ( 0.005 mg,ml

"ypes o! Anesthesia# Duration# andmg$lb recommendations

Short to Medium Acting Amide Drugs Long Acting Amide Drugs

&epiviacine -Carbocaine / "/#! -".0 mg,lb. upivicaine -&arcaine .5! / -0.) mg,lb.Lidocaine -locaine "! / -".0 mg,lb. 2tidocaine 1.5! / -#.) mg,lb.

3rilocaine $! / -".*mg,lb

Articaine $! / -#." mg,lb.

&a'imum 4 of cartridges is determined b:

eight of person -average is 150 lbs. recommended mg,lb. ( ma'. amt.

eight+ LA tpe+ with or without 2pinephrine+ health of patient

&67 of LA calculation is percentage of LA Agent 1.8 ml of solution

7ivide &67 based on weight -mg,cartridge &a'imum 4 of cartridges

&a'imum of 2pinephrine is ." mg for a health person and .0$ compromised

Amt. of &67 epi divided b amt. of epi in cartridge ( &67 of LA with 2pinephrine

%&AM'L%

2* Lidocaine at "mg,lb recommended dose

1. 150 lbs. " ( #00 mg &67

". "! 1.8 ml ( #) mg

#. #00,#) ( 8.)) cartridges ma'imum

Epinephrine:

1. 1:100+000 ( .01 mg,ml 1.8 ml ( 0.018 in each cartridge

a. .01 1.8 ( 0.018b. .",.018 ( 11 cartridges however+ this e'ceeds &67 for Lidocaine. .018 8.## cartridges ( 0.1$9 epiwhich is below the ." mg recommended. %herefore+ ou would ma' out on Lidocaine before epi. o+

8.)) cartridges ma'imum for Lidocaine w,1:100 epi

". 1:50+000 ( 0.0" 1.8 ( 0.0#) in each cartridge

a. .0" 1.8 ( 0.0#)

b. .",0.0#) ( 5.55 cartridges ma'imum ;epi is dose limited factor

Mepi+icaine or ,arbocaine -* plainat "mg,lb recommended dose

1. 150 " ( #00

". #! 1.8 ( 5$ mg

1

8/12/2019 MRD for LA Calculations.oct.2013

2/6

#. #00,5$ ( 5.55 cartridges ma'imum

;a if controlled

Gmpaired liver or >idne function onl if severel impaired

&alignant perthermia amides are safe &ethemoglobinemia avoid 3rilocaine and Articaine

eart failure+ heart attac>+ recent heart surger+ hpertension limitation of epi is case dependent

8/12/2019 MRD for LA Calculations.oct.2013

3/6

#

8/12/2019 MRD for LA Calculations.oct.2013

4/6

Local Anesthetics

&echanism of Action: bloc> peripheral nerve conduction b decreasing the sodium ion permeabilit of the nerve

membrane. HGnhibit the influ' of sodium ionsI b bloc>ing sodium channels in the neuron membrane.

2'creted b the >idnes

8/12/2019 MRD for LA Calculations.oct.2013

5/6

5

8/12/2019 MRD for LA Calculations.oct.2013

6/6

)