• Complete and document a neurologic examination
before injecting the anesthetic.
• Do not use epinephrine in the digits because it can result in
ischemia, necrosis, and potential loss of the digit.
• The maximum lidocaine dose is 5 mg/kg (1% lidocaine has
10 mg/mL; 2% has 20 mg/mL).
• The maximum bupivacaine dose is 2 mg/kg.
• A lidocaine injection provides approximately 2 hours of pain
control, while a lidocaine/bupivacaine mixture (1:1) provides
approximately 5–7 hours of pain relief.