In kids, there’s much less in the way of hard 24 h limits (and a lot of different numbers floating around) so we most commonly think in terms of infusion rates. For ropivacaine, 0.3-0.5 mg/kg/h is generally well-tolerated in most kids…with adjustments for the very young: for 0-4 months use 0.2 mg/kg/h; for 5-12 months use 0.3 mg/kg/h. @mfettiplace , @BrittaniBungart and team did a really great paper on this recently—worth a read: pubmed.ncbi.nlm.nih.gov/3742…

This is a great question—we often think about single doses but not cumulative. The drug label in the U.S. says “Experience to date indicates that a cumulative dose of up to 770 mg Naropin administered over 24 hours is well tolerated in adults when used for postoperative pain management”. That’s what our team uses as a limit. So that means catheters infusing 0.2% can run a total of 16 ml/hr (our limit for 2 catheters is 8+8 for this reason). 16 ml x 2 mg/ml x 24 hr = 768 mg. That’s for adults…(1/2) @mfettiplace @lipidguy @ASRA_Society @DaraEsra @ESRA_Society @BlockIt_Hot_Pod @EMARIANOMD @James_Kim_MD @RegionalAnaesUK