Lidocaine Maximum Dose — FRCA Primary MCQ

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HardPharmacology - AnalgesicsLidocaine Maximum DoseFRCA Primary

A 60 kg patient has already received 200 mg lidocaine during a block. Further infiltration will use lidocaine 1% with adrenaline. Ignoring any need for a more conservative patient-specific limit, what additional volume reaches the SmPC ceiling of 7 mg kg−1?

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Correct answer: E — 22 mL

The best answer is “22 mL”. Seven milligrams per kilogram in a 60 kg adult gives 420 mg total. After 200 mg has already been administered, 220 mg remains. Lidocaine 1% contains 10 mg mL−1, so 220 mg corresponds to 22 mL. Every lidocaine-containing preparation must be included; the numerical ceiling does not remove the obligation to use the smallest effective dose.

Reference: Lidocaine Injection BP 2% w/v, UK SmPC: https://www.medicines.org.uk/emc/product/15150/smpc; Royal College of Anaesthetists, Primary FRCA syllabus v2.2: https://www.rcoa.ac.uk/sites/default/files/documents/2026-01/Primary-FRCA-Syllabus.pdf