lidocaine for IO infusion pain

28 Mar

I looked this up again recently, figured I’d save some of you the trouble:

Lidocaine 2%

  • 40mg through the IO catheter over about two minutes,
  • followed by a 10 mL normal saline bolus over five seconds.
  • An additional 20 mg of lidocaine was then administered over 30 seconds.


Lidocaine 2%  is 20mg/ml -> so ~2 mL will get you your 40mg dose



If you’re worried about toxic doses, here’s a refresher:

Lidocaine max dose 4.5mg/kg

for the average 70kg patient:

70kg * 4.5mg/kg = 315mg

315mg / 20mg/ml (for 2% lido) = ~15 ml max



Lidocaine 2% – use 2 mL slow IO push (over 2 minutes in the referenced study), 10cc NS flush.

May benefit from an additional 1 mL slow IO push of 2% lido.


References: JEMS article; picture


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