From the Guidelines
The maximum dosage of lidocaine for a pediatric patient is 7.0 mg/kg when used with epinephrine and 4.4 mg/kg without epinephrine, as stated in the guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures 1.
Key Considerations
- The dosage of lidocaine should be calculated carefully to avoid excessive doses, especially in infants younger than 6 months, where doses of amides should be decreased by 30% 1.
- The duration of action for lidocaine in pediatric patients typically ranges from 90 to 200 minutes, depending on the specific formulation and route of administration 1.
- It is essential to note that lower doses should be used in very vascular areas, and the practitioner should aspirate frequently to minimize the likelihood of injecting the needle into a blood vessel 1.
- The guidelines also recommend avoiding unnecessary exposure to sedation if the procedure is unlikely to change medical or dental management, especially in preterm infants 1.
Important Details
- The maximum recommended doses and durations of action for lidocaine are shown in the guidelines, with notes on the use of epinephrine and the patient's age 1.
- The guidelines also provide information on the use of other local anesthetic agents, such as procaine, chloroprocaine, and bupivacaine, with their respective maximum doses and durations of action 1.
- A study from 2006 also supports these guidelines, providing similar information on the maximum doses and durations of action for local anesthetic agents, including lidocaine 1.
From the FDA Drug Label
Pediatric Patients It is difficult to recommend a maximum dose of any drug for pediatric patients, since this varies as a function of age and weight For children over 3 years of age who have a normal lean body mass and normal body development, the maximum dose is determined by the child’s age and weight. For example, in a child of 5 years weighing 50 lbs the dose of lidocaine HCl should not exceed 75 to 100 mg (1. 5 to 2 mg/lb). The maximum dosage of lidocaine for a pediatric patient is 1.5 to 2 mg/lb of body weight, as illustrated by the example of a 5-year-old child weighing 50 lbs, where the dose should not exceed 75 to 100 mg. 2