Disclaimer
is PocketGuide attempts to define principles of practice that should produce high-quality
patient care. It should not be considered exclusive of other methods of care reasonably directed
at obtaining the same results. e ultimate judgment concerning the propriety of any course of
conduct must be made by the clinician aer consideration of each individual patient situation.
e views and opinions contained in this PocketGuide are those of the contributors and are
not approved or endorsed by affiliated institutions or associations. Neither IGC, medical
associations, nor the authors endorse any product or service associated with the distributor of
this clinical reference tool.
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Onset and Duration of Local Analgesic Action
*
Onset
(min)
Duration
(hr)
Prolongation
With
Epinephrine
Toxic Dose
With Single
Administration
Lidocaine <5 ½-1 ++ 4-5 mg/kg
(7 mg/kg with
epinephrine)
Bupivacaine 5 ~3-6 +/− 1.7-2 mg/kg
Mepivacaine <5 ¾-1½ ++ 4-5 mg/kg
(7 mg/kg with
epinephrine)
Ropivacaine 1½-3 +/− 3 mg/kg
Bupivacaine
liposome
injectable
suspension
19
5 Up to 72 N/A Safety data up to
532 mg
(266 mg per
surgical site)
Key: ++, significant potentiation; +/−, some potentiation; N/A, not applicable.
*Adapted from Sinatra et al. Surgeon's Guide to Postsurgical Pain Management.
20
Overview of Local Analgesics
Infiltration Technique Videos
Î To enhance the local analgesic infiltration techniques described and
illustrated in this Best Infiltration Practices PocketGuide, members of
the Working Group have provided narrated videos of the techniques.
