Local anesthetic dosages: a new look at an old drug.
You have administered 4 carpules of 2% Lidocaine with 1:100,000 to a hypertensive patient. Which amount below represents the correct dose of epinephrine the patient received (expressed in micrograms)?
That is correct!
Explanation: An epinephrine concentration of 1:100,000 is 10 mcg (mcg = micrograms) of epinephrine per ml. To simplify the math, let's over estimate the volume at 2 cc per dental carpule rather than the peculiar dose of 1.7 or 1.8 cc. This is safe practice for estimating dosages. Each carpule of local anesthetic with epinephrine in a 1:100,000 concentration has 20 mcg of epinephrine per carpule. See below:
10 mcg/ml x 2.0 cc/carpule = 20 mcg epinephrine/carpule
4 carpules x 20 mcg= 80 mcg epinephrine
There is no maximum dose of epinephrine recommended. However it is prudent to have a baseline blood pressure and monitor the blood pressure during the appointment. By way of comparison, the epinephrine dose for treatment of anaphylaxis is 300mcg.
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