What is the widely accepted maximum dose of lidocaine used for tumescent liposuction?
55 mg/kg. While this maximum dose is widely accepted, there have been cases of local anesthetic toxicity in some patients. A pharmacokinetic study performed in health volunteers by Klein JA et al, however, demonstrates that doses of 45 mg/kg result in Cmax lidocaine concentrations < 6 mcg/ml. The authors estimate that the risk of lidocaine toxicity with liposuction at a dose of 45 mg/kg was less than or equal to 1 per 2000.
Klein JA et al. Estimated Maximal Safe Dosages of Tumescent Lidocaine. Anesth Analg. 2016; 122(5): 1350-1359. 2. Thumtecho S et al. Lidocaine overdose: tumescent liposuction jeopardy. Clin Tox 2022. Published online 7 March 2022.