Infraorbital Nerve Block: Dosing Guidelines, Safety Precautions, and Pediatric Recommendations

Adult Dosing Guidelines

• The American Academy of Dermatology recommends a maximum lidocaine dose of 4.5 mg/kg (without epinephrine) for adult patients undergoing lip laceration repair. 1
• The American Academy of Dermatology recommends a maximum lidocaine dose of 7 mg/kg (with epinephrine) for adult patients undergoing lip laceration repair. 1
• Buffering lidocaine with sodium bicarbonate reduces injection pain when infiltrative techniques are used, according to the American Academy of Dermatology. 1

Safety Precautions

• Do not perform an infraorbital nerve block within 4 hours of intravenous lidocaine administration, as the combined local anesthetic exposure increases toxicity risk (Anaesthesia). 2, 3

Pediatric Recommendations

• Bilateral infraorbital nerve blocks are specifically recommended for cleft‑lip repair in children (Anaesthesia). 4, 5, 6
• For landmark‑based maxillary nerve blocks in pediatric patients, the advised dose is 0.15 mL/kg of either bupivacaine 0.25 %, levobupivacaine 0.25 %, or ropivacaine 0.2 % (Anaesthesia). 7, 8