Lipid Rescue for Local Anesthetic Toxicity
Computes the 20 percent lipid emulsion volumes for local anesthetic systemic toxicity from the patient weight.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Patient weight, kg
- 80 kg
Result: a 100 mL bolus at 80 kg, with an upper limit of 960 mL
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 70 kg or above
- A 100 mL bolus of 20 percent lipid emulsion over 2 to 3 minutes, then 200 to 250 mL over 15 to 20 minutes.
- Under 70 kg
- 1.5 mL per kilogram over 2 to 3 minutes, then 0.25 mL per kilogram per minute. Upper limit about 12 mL per kilogram.
- Timing
- Lipid goes early, not at cardiac arrest. The checklist starts it at the first sign of serious toxicity, and waiting for arrest is the delay it was written to prevent.
- Epinephrine
- Reduced to 1 microgram per kilogram or less, roughly a tenth of the usual dose, because larger doses impair resuscitation from this toxicity.
- Propofol
- Not a substitute for lipid emulsion. Its lipid content is far too low to matter, and it is harmful in a cardiovascularly unstable patient.
- Avoided
- Vasopressin, calcium channel blockers, beta blockers, and any further local anesthetic.
What you enter
- Patient weight, kg
- In cardiac arrest (changes the epinephrine wording, not the lipid dose)
How this is calculated
Neal JM, Neal EJ, Weinberg GL. American Society of Regional Anesthesia and Pain Medicine local anesthetic systemic toxicity checklist: 2020 version. Reg Anesth Pain Med. 2021;46(1):81-82. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.