Levobupivacaine is the local anaesthetic of choice due to its duration of action (10-12 hours). The maximum dose of Levobupivacaine is 2mg/kg (based on lean body weight).
SAPB is a volume block; to be effective, a reasonable volume must be injected.
40mls of 0.25% levobupivacaine (100mg) is a standard dose in patients over 50kg.
If using 0.5% levobupivacaine, 20ml of 0.5% levobupivacaine (100mg) can be diluted in 20ml of 0.9% saline to give a total volume of 40ml.
If patients are below 50kg, the dose must be adjusted.
Local anaesthetic can be provided to skin at the insertion point prior to performing the block with 1 – 2ml of 1% lidocaine (10-20mg). Note that the total local anaesthetic dose should not exceed the combined maximum dose.