What is the maximum dose of lignocaine?

The maximum dose of lignocaine (lidocaine) is 3mg/kg without adrenaline and 7mg/kg with adrenaline (1:200,000). For a 70kg adult, this is 210mg (10.5ml of 2%) without adrenaline or 490mg (24.5ml of 2%) with adrenaline. Always use the lowest effective dose.

What is the maximum dose of bupivacaine?

The maximum dose of bupivacaine (Marcain) is 2mg/kg without adrenaline and 2.5mg/kg with adrenaline. For a 70kg adult, this is 140mg (28ml of 0.5%) without adrenaline. Bupivacaine has a longer duration of action (2-8 hours vs 1-2 hours for lignocaine).

Local Anaesthetic Dosing

Calculate maximum dose by patient weight for lignocaine and bupivacaine.

📋 Source: Maximum safe doses per Therapeutic Guidelines, Austin Health Local Anaesthetics guideline, and standard toxicology references. Lignocaine 3mg/kg without adrenaline (7mg/kg with adrenaline), bupivacaine 2mg/kg. Published maximum lignocaine doses vary by source (commonly 3–4.5mg/kg plain) — this calculator uses the more conservative figure; always confirm against your local formulary/eTG.
Your doctor or healthcare provider knows your history and circumstances — always follow their personalised advice over general information.

⚠ Clinical tool — always use the lowest effective dose. Consider patient factors: age, hepatic impairment, cardiac disease, pregnancy.

Patient weight (kg)

Traditionally avoided in end-arteries: fingers, toes, ears, nose, penis ("fingers, toes, nose, and hose"). However, current evidence supports the safe use of low-concentration adrenaline (1:200,000) in digital blocks — multiple studies and systematic reviews have shown no increased risk of ischaemia.

Many Australian GPs and hand surgeons now routinely use lignocaine with adrenaline for digital blocks. Follow your local guidelines and clinical judgement.

Do avoid adrenaline in: patients with severe peripheral vascular disease, Raynaud's phenomenon, or when injecting into tissue with compromised blood supply.

CNS (early): Perioral tingling, metallic taste, tinnitus, dizziness, visual disturbance, confusion, agitation.

CNS (late): Seizures, loss of consciousness.

CVS: Bradycardia, hypotension, arrhythmias, cardiac arrest.

Management: Stop injection. ABCs. IV lipid emulsion (Intralipid 20%) for severe toxicity — 1.5ml/kg bolus then 0.25ml/kg/min infusion. Call for help early.

1% = 10mg/ml. 2% = 20mg/ml. 0.25% = 2.5mg/ml. 0.5% = 5mg/ml.

Adrenaline 1:200,000 = 5 micrograms/ml. Adrenaline 1:100,000 = 10 micrograms/ml.

Local Anaesthetic Dosing

Lignocaine (Lidocaine)

Bupivacaine (Marcain)

Prilocaine (Citanest)