Epidural lidocaine dosing for intrapartum cesarean delivery: do the current guidelines fit clinical practice?

Administration of lidocaine through an indwelling labor epidural catheter is a common anesthetic technique for cesarean delivery (CD).1 Our anecdotal experience suggests that patients frequently receive large doses of epidural lidocaine for CD anesthesia. However, the incidence of exceeding recommended lidocaine dosing package inserts2 for CD anesthesia is unknown.