Bupivacaine Dosage Guidelines for Epidural Anesthesia

Concentration-Specific Dosing for Epidural Use

The American Society of Anesthesiologists recommends an initial dose of 0.5 ml/kg of 0.25% bupivacaine (maximum 15 ml) for lumbar epidural in adults 1, 2
The American Society of Anesthesiologists recommends an initial dose of 0.2-0.3 ml/kg of 0.25% bupivacaine (maximum 10 ml) for thoracic epidural in adults 1, 2
For pediatric populations, the maximum dose is 1 ml/kg of 0.25% bupivacaine (equivalent to 2.5 mg/kg) 1, 2
For caudal block in pediatric populations, the recommended dose is 1.0 ml/kg of 0.25% bupivacaine 1, 2

For patients weighing less than 40 kg, doses should be calculated carefully, and for obese patients, ideal body weight should be used 2