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Local anaesthetic dose calculator
Maximum safe dose and volume of local anaesthetic for an adult, using lean body weight.
For adults. Enter the patient's details and the drug to see the maximum single dose and the largest volume that stays under it. Maximum doses are only a guide: always use the lowest dose that works.
Enter a weight to start.
Maximum single doses used here
| Drug | mg/kg | Upper limit |
|---|---|---|
| Lidocaine (plain) | 3 mg/kg | 200 mg |
| Lidocaine with adrenaline | 7 mg/kg | 500 mg |
| Prilocaine (plain) | 6 mg/kg | 400 mg |
| Bupivacaine (with or without adrenaline) | 2 mg/kg | 150 mg |
| Levobupivacaine | 2 mg/kg | 150 mg |
| Ropivacaine | 3 mg/kg | 225 mg |
- Lean body weight is used when you enter a height, because doses based on actual weight can be too high in obese patients. It is worked out with the Janmahasatian formula.
- Mixing drugs: the toxic effects add up. Tick "Mix two drugs" to work out each drug's share of its own maximum; the total must stay under 100%. Only two drugs can be combined here.
- Where you inject matters: absorption is fastest after intercostal and fascial plane blocks and slower after plexus blocks and subcutaneous injection. Adding adrenaline slows absorption.
- Infusions and repeat doses build up over time. These numbers are for a single dose.
- Be ready to treat toxicity: see the LAST protocol.
Sources: El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth 2018;11:35–44. Neal JM, Barrington MJ, Fettiplace MR, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity: Executive Summary 2017. Reg Anesth Pain Med 2018;43:113–123. Rosenberg PH, Veering BT, Urmey WF. Maximum recommended doses of local anesthetics: a multifactorial concept. Reg Anesth Pain Med 2004;29:564–575. Janmahasatian S, Duffull SB, Ash S, et al. Quantification of lean bodyweight. Clin Pharmacokinet 2005;44:1051–1065. Dose limits follow UK product information. A guide for trained clinicians only: it does not replace clinical judgement or your hospital's policy.