Peripheral Nerve Block or Wound Infiltration

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Click here to access the Adult Hospital Level Chapter 12: Anaesthesiology and Intensive Care with supporting NEMLC Report_2025-9-Version-1.0_26-February-2026

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Only preservative free medicines may be used for nerve blocks.
Lidocaine has a faster onset of action than bupivacaine, but a shorter duration of action.

• Lidocaine 1% or 2%.
  • Higher concentrations cause more pain on injection.
  • Maximum dose: 3 mg/kg.
• Lidocaine 2% plus adrenaline.
  • Not to be used in areas supplied by an end-artery e.g. finger, ear, penis.
  • Maximum dose: 7 mg/kg.
• Bupivacaine 0.5%
  • Not be used in mucosal areas as risk of systemic toxicity.
  • Maximum dose: 2 mg/kg.

LoE:III³⁷

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2024 Edition