Bupivacaine dosing
Local Anesthetics · 0.25-0.5% (2.5-5 mg/mL) · Infiltration / Nerve Block / Epidural
Calculated, not generatedWeight-based dose
| Dose | Per kg | For 70 kg |
|---|---|---|
| low | 1.5 mg/kg | 105 mg |
| standard | 2.5 mg/kg | 175 mg |
| high | 3 mg/kg | 210 mg |
Max without epi: 2.5 mg/kg. Max with epi: 3 mg/kg. Cardiotoxic risk.
Renal & hepatic adjustment
- Severe (Child-Pugh C)Amide local — reduced hepatic clearance; lower the maximum dose and watch for systemic toxicity (LAST).
Source: ASRA LAST guidance
Onset, duration & pearls
Onset5-10 min
Duration4-8 hr
Side effects: Cardiotoxicity (refractory VF), CNS toxicity (seizures).
- Highest cardiotoxicity of amide LAs — have intralipid ready
- S-enantiomer (levobupivacaine) is less cardiotoxic
Evidence A · Standard local anesthetic, well-characterized toxicity
More local anesthetics
Get the exact dose for your patient
Vigil computes Bupivacaine for your patient's actual weight — and adjusts for renal or hepatic impairment automatically, with the cited rationale. The number is calculated from a verified database, never guessed.
Decision support for licensed clinicians — not a substitute for clinical judgment. Always verify against the package insert and the patient in front of you.