Local Anaesthesia — ORE Part 1 MCQ
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Correct answer: A — 7 mg/kg (490 mg)
Explanation lettering: E = shown as B · D = shown as C · B = shown as D · C = shown as E
<cite index="4-2">The maximum single dose of lidocaine when given with adrenaline is 500 mg</cite> according to UK SmPC guidance (eMC). For a 70 kg adult, this represents approximately 7.1 mg/kg. Option A (7 mg/kg = 490 mg) is the correct maximum recommended dose. Options B, C and D represent doses below the recommended maximum. Option E (10 mg/kg = 700 mg) exceeds the 500 mg absolute maximum and represents a dose that risks central nervous system and cardiac toxicity. In UK dental practice, this 500 mg maximum (with adrenaline) applies to infiltration and regional blocks in healthy patients.
Reference: UK Electronic Medicines Compendium (eMC): Lidocaine 2% with adrenaline (epinephrine) 1:200,000 solution for injection - Summary of Product Characteristics. medicines.org.uk/emc/product/2396/smpc, https://www.medicines.org.uk/emc/product/2396/smpc