A Nomogram for Calculation of Maximum Recommended Dose by Volume of Local Anesthetic in Pediatric Dentistry.

PURPOSE: Calculation of maximum recommended doses for local anesthetic agents and added vasopressors is complex and error-prone with potentially fatal consequences. The purpose of this investigation was to develop a nomogram to calculate the maximum recommended doses, expressed as volumes (number of cartridges or ml) of local anesthetic for healthy U.S. pediatric dental patients based on body weight, and test its accuracy and reproducibility.

METHODS: Standard mathematical techniques were used to draft the nomogram. Validation was performed using simulated patient data, and Bland-Altman analysis was used to evaluate the accuracy and repeatability of the nomogram.

RESULTS: The nomogram was found to have a bias of 0.01 ml, with limits of agreement -0.04ml to 0.06ml and, thus, was considered to be within an acceptable range for clinical use.

CONCLUSION: Our nomogram rapidly calculated the maximum recommended doses by volume of local anesthetic agents in common use to a high degree of accuracy and repeatability.