For pain associated with IO infusion, what is the lidocaine IO dose?

• A. Lidocaine 0.5 mg/kg slow IO push over two minutes
• B. Lidocaine 1.0 mg/kg slow IO push over two minutes
• C. Lidocaine 0.25 mg/kg IO push over 1 minute
• D. Lidocaine 2.0 mg/kg IO push over 3 minutes

Answer: (A)

The concept here is using a small, weight-based dose of lidocaine directly into the IO line to reduce pain from IO infusion. The standard choice is 0.5 mg/kg given as a slow IO push over about two minutes, with a practical maximum (often 40 mg). Administering it slowly helps localize the anesthetic effect at the IO site while minimizing rapid systemic absorption, which lowers the risk of lidocaine toxicity or cardiac/neurologic effects. Doses that are higher (1.0 mg/kg or 2.0 mg/kg) or much lower (0.25 mg/kg) either raise safety concerns or may fail to provide adequate analgesia. This is why the 0.5 mg/kg over two minutes option is the best.