Most cardiotoxic local anaesthetic is
High-Yield Explanation
Bupivacaine (Sensoricaine, Marcaine)Bupivacaine is 2nd most commonly used local anaesthetic (after lidocaine)Bupivacaine has the highest local tissue irritancy amongst local anaestheticsIt is the most cardiotoxic local anaestheticLevobupivacaine (The S(-) enantiomer of bupivacaine) is less cardiotoxic and less prone to cause seizureConcentrations used for bupivacaine are:- Nerve block: 0.5%, epidural: 0.25 -0.5%, and spinal: 0.5%Maximum safe dose is 2mg/kg without adrenaline and 3mg/kg with epinephrine (Refer: stoelting's pharmacology and physiology in anaesthetic practice, 5th edition, pg no.294)