What is the maximum total lidocaine dose per kilogram allowed during pediatric resuscitation when used as an antiarrhythmic?

What is the maximum total lidocaine dose per kilogram allowed during pediatric resuscitation when used as an antiarrhythmic?

• A. 3 mg/kg
• B. 1 mg/kg
• C. 6 mg/kg
• D. 2 mg/kg

Answer: (A)

Lidocaine is used in pediatric resuscitation as a fast-acting antiarrhythmic, but it has a narrow safety margin, so dosing is kept to a strict limit. The plan allows an initial 1 mg/kg IV bolus, and if the arrhythmia persists, up to two additional boluses of about 0.5–0.75 mg/kg can be given. This adds up to a total maximum of 3 mg/kg. Staying at or below this cap helps minimize lidocaine toxicity, which can present as central nervous system symptoms (drowsiness, confusion, seizures) and cardiovascular depression (hypotension, bradycardia). If the arrhythmia remains after reaching the maximum bolus dose, other antiarrhythmics like amiodarone may be considered.

Lidocaine is used in pediatric resuscitation as a fast-acting antiarrhythmic, but it has a narrow safety margin, so dosing is kept to a strict limit. The plan allows an initial 1 mg/kg IV bolus, and if the arrhythmia persists, up to two additional boluses of about 0.5–0.75 mg/kg can be given. This adds up to a total maximum of 3 mg/kg. Staying at or below this cap helps minimize lidocaine toxicity, which can present as central nervous system symptoms (drowsiness, confusion, seizures) and cardiovascular depression (hypotension, bradycardia). If the arrhythmia remains after reaching the maximum bolus dose, other antiarrhythmics like amiodarone may be considered.