As mentioned in the ASA Monitor (, local anesthesia toxic doses can be difficult to estimate. When using perioperative local anesthetics, our practice:

We have no systematic, organized method of calculating dose limits or obtaining rescue materials.
We standardize dose limits and we can obtain rescue items from our pharmacy.
We maintain standardized dose limits and keep rescue items (Intralipid, code cart, manual) in an easily accessed area close to patient care areas or ORs.

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