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Lipid emulsion for local anesthetic toxicity

The ASRA checklist branches at 70 kg rather than scaling: above it the bolus and infusion are fixed volumes, below it they are per kilogram. This shows the arm that applies and the cumulative ceiling that limits it.

kg
Enter a weight to see which arm of the checklist applies.

The ASRA checklist branches at 70 kg rather than scaling: at or above it the bolus and infusion are fixed volumes for every patient. Below it they are per kilogram. The checklist states no maximum dosing weight, so none is applied here.

Formula

  • Lipid emulsion at or above 70 kg = a fixed 100 mL bolus, then about 250 mL over 15 to 20 minutes
  • Lipid emulsion below 70 kg = 1.5 mL/kg bolus, then 0.25 mL/kg/min
  • Lipid emulsion cumulative maximum = 12 mL/kg

Source

  • ASRA Pain Medicine Checklist for Treatment of Local Anesthetic Systemic Toxicity (2020 version), Reg Anesth Pain Med 2021;46:81-82.

Clinical reference only. Verify independently; clinical judgment governs.