Use AAPD's 4.4 mg/kg ceiling, then reduce as indicated and use the lowest effective total dose.
- A 20-kg child has a calculated ceiling of 88 mg before reductions.
- 2% lidocaine is 20 mg/mL: 88 mg corresponds to 4.4 mL, not a target dose.
- Verify cartridge volume; 1.7 mL contains 34 mg, while 1.8 mL contains 36 mg.
- Account for topical absorption, medical modifiers, and concurrent depressants.