What is the recommended maximum dosage for lidocaine with epinephrine in healthy adults?

The recommended maximum dosage for lidocaine with epinephrine in healthy adults is determined by considering both the lidocaine's inherent properties and the effects of epinephrine. In practice, the maximum safe dose of lidocaine without epinephrine is generally around 5 mg/kg for a healthy adult. However, when epinephrine is added, it allows for a higher maximum dose due to its vasoconstrictive properties, which prolong the action of the anesthetic and reduce systemic absorption.

For lidocaine specifically, when combined with epinephrine, the safe maximum dosage can reach about 7 mg/kg, often cited as around 500 mg for an average adult weighing approximately 70 kg. This is why the figure of 500 mg is frequently used as a standard for safe practice. It is essential to be aware of a patient's health status and any contraindications to epinephrine usage when determining the appropriate dosage in clinical scenarios.

Thus, the selection of 500 mg as the maximum dosage reflects a safe practice standard, enabling effective local anesthesia while minimizing the risk of systemic toxicity.