Local Anesthetic Doses

  1. Q:
    How do you figure out the max dose of two seperate LA's given together? For example, if you dose a spinal/epidural and then during the case the surgeon wants to inject local, how do you figure out how much they can safely give?
    I know they are additive but is there a specific formula for this?
  2. 2 Comments

  3. by   Tenesma
    when they start seizing or having fatal arrhythmias... then you have given too much

    just kidding... there is no good literature and the literature that is quoted is primarily based on anecdotal experience... read goodman & gilman's or read the package inserts for each individual drug.... while the effects of 2 Local Anesth. can be additive as far as anesthesia is concerned, it doesn't imply that their cardiac/neuro effects are additive as well (usually they aren't).
  4. by   Gump
    Tenesma, you crack me up :chuckle