Anesthesia Basics

Question 1

How much Lidocaine and epi in 2% conc w/ 1:100k epi in 1.7mL carpule?

Answer 1

2%= 34 mg/ carpule; epi 1:100,000= 0.017mg/ carpule

Lidocaine: 2%=2g/100cc x 1000mg/1g x 1.7 cc/ carpule= 34 mg/ carpule

Epinephrine; 1:100,000= 1g/100,000cc x 1000 mg/1g x 1.7 cc/ carpule= 0.017 mg/carpule

1.7mL carp Local anesthetic

1%= 17 mg/ carpule

2%= 34 mg/ carpule

3%=51 mg/ carpule

0.5%= 8.5 mg/ carpule

Epinephrine

1: 100,000= 0.017mg/ carpule
1: 200,000= 0.0085 mg/ carpule
1: 50,000= 0.034 mg/ carpule

Question 2

Max dose of 2% Lido w/ 1:100k epi for 70kg man?

Answer 2

Dose =7mg/kg–> 7x70=490mg

490/34=14.41 round down to 14 carps

maximum safe dose of 2% lidocaine w/epinephrine 1:100,000 (0.01 mg/mL) is 20 mL

MAX dose epi 1:100k=0.2mg

.2/.017=11.76 round down to 11, MAX dose based off MAX epi dose

11 carps

Question 3

MAX dose local anesth chart

Answer 3

Question 4

Out of Lido, Bupivicaine, and Articaine, which takes the longest to start working?

Answer 4

Bupivicaine=5 to 8min, pka=8.1, also lasts the longest (duration=protein binding)

higher the pka=longer the onset

Question 5

Max dose of 0.5% Bupivicaine w/ 1:200k epi in 1.8mL carp?

Answer 5

1.3mg/kg if less than 70kg or 90mg if equal/greater to 70kg

Question 6

Max dose 4% Articaine w/ 1:100k epi or 1:200k epi?

Answer 6

7mg/kg, MAX 500mg

1:200k= more weak, lasts less 120-300min in soft tiss versus 180-360 min 1:100k

72mg LA per 1.8 carp

Question 7

MAX dose 2% Lidocaine w/ and w/out 1:100k epi?

Answer 7

36mg Lido in 1.8mL carp

NO epi=4.5mg/kg=2mg/Ib, MAX 300

1:100k=7mg/kg=3.2mg/Ib, MAX 500