Peripheral nerve block or wound infiltration

Only preservative free medicines may be used for nerve blocks.

Lidocaine has a faster onset of action than bupivacaine, but a shorter duration of action.

  • Lidocaine 1% or 2%.
    • Higher concentrations cause more pain on injection.
    • Maximum dose: 3 mg/kg.
  • Lidocaine 2% plus adrenaline.
    • Not to be used in areas supplied by an end-artery e.g. finger, ear, penis.
    • Maximum dose: 7 mg/kg.
  • Bupivacaine 0.5%
    • Not be used in mucosal areas as risk of systemic toxicity.
    • Maximum dose: 2 mg/kg.

LoEIII [37]