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Local Anaesthetic Max Dose

Adult & paediatric — max dose, volume, infusion limits & combined toxicity
⚠️ Education only — maximum doses/rates are a guide; verify against local formulary. LAST is an emergency (lipid emulsion).
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Adult maxima (approx — verify locally): Lidocaine 3 mg/kg (7 w/adrenaline); Bupivacaine 2 (2.5 w/adr); Levobupivacaine 2; Ropivacaine 3; Prilocaine 6 (8 w/adr); Mepivacaine 4.4 (7 w/adr); Chloroprocaine 11. Absolute per-dose caps applied. In obesity use ideal/lean weight.

Paediatric (ESRA/ASRA 2018): single-shot bolus caps as above; continuous infusion — bupivacaine/levobupivacaine ≤0.2 mg/kg/hr if ≤6 months, ≤0.4 mg/kg/hr if older; ropivacaine ≤0.2 (0–4 mo), ≤0.3 (5–12 mo), ≤0.4 mg/kg/hr (>12 mo). Infants <6 months: additional ~30% reduction (higher free fraction, lower clearance). High-risk: reduce a further ~50%. Amino-amide short-acting/ester agents are not used for continuous infusion here.

Values pending clinical review. Sources: Suresh S, et al. ESRA/ASRA recommendations, Reg Anesth Pain Med 2018; BNF for Children; product information.