For a 70 kg patient, what is the maximum recommended dose of bupivacaine?

For a 70 kg patient, what is the maximum recommended dose of bupivacaine?

• A. 140 mg
• B. 210 mg
• C. 260 mg
• D. 320 mg

Answer: (B)

Bupivacaine safety is determined by weight and whether a vasoconstrictor is used. When epinephrine is added, the maximum recommended dose increases to about 3 mg per kilogram because vasoconstriction slows the drug’s absorption, lowers peak plasma concentrations, and reduces toxicity risk. For a 70 kg patient, that yields 210 mg (70 × 3). Without a vasoconstrictor, the limit is typically about 2 mg/kg, which would be 140 mg for this patient. So 210 mg is the best answer because it reflects the higher per-kilogram limit when epinephrine is used, accounting for safer systemic exposure.

Bupivacaine safety is determined by weight and whether a vasoconstrictor is used. When epinephrine is added, the maximum recommended dose increases to about 3 mg per kilogram because vasoconstriction slows the drug’s absorption, lowers peak plasma concentrations, and reduces toxicity risk. For a 70 kg patient, that yields 210 mg (70 × 3). Without a vasoconstrictor, the limit is typically about 2 mg/kg, which would be 140 mg for this patient. So 210 mg is the best answer because it reflects the higher per-kilogram limit when epinephrine is used, accounting for safer systemic exposure.