What is the maximum recommended dose of lidocaine without epinephrine for adults?

The maximum recommended dose of lidocaine without epinephrine for adults is 5 mg/kg. This dosage is based on the pharmacokinetics and safety profile of lidocaine, a commonly used local anesthetic. Administering doses higher than this can increase the risk of systemic toxicity, including serious cardiovascular and neurological side effects.

Understanding this limit is essential for safe practice, as lidocaine disperses quickly in the systemic circulation, and exceeding the recommended dose can lead to adverse reactions. However, the presence of epinephrine can allow for higher doses by causing vasoconstriction and prolonging the anesthetic effect, which is why different dosing guidelines exist when it is included in the formulation. This distinction underscores the importance of recognizing the context of lidocaine's administration – whether with or without epinephrine.