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This is because the lidocaine maximum dosage (3 mg/kg) used in a Bier block is twice the cardiac dose of lidocaine (1.
The maximum lidocaine plasma concentration from a Bier block after a properly cycled tourniquet release is 2 [micro]g/mL to 4 [micro]g/mL plasma concentration.
If more anesthetic is needed in 10 minutes, continue to the full dose Bier block.