However, when 1.25 mL/kg is injected there is a danger of excessive rostral spread (above T4); it is therefore preferable not to administer more than 1.0 mL/kg of local anesthetic.

EPIDURAL:
Bupivacaine, levobupivacaine- initial dose : Solution: 0.25% with 5 µg/mL (1/200,000) epinephrine

Dose:<20 kg: 0.75 mL/kg20-40 kg: 8-10 mL (or 0.1 mL/year/number of metameres)>40 kg: same as for adults
Continuous infusion- maximum doses: <4 mo: 0.2 mg/kg/hr (0.15 mL/kg/hr of a 0.125% solution or 0.3 mL/kg/hr of a 0.0625% solution)4-18 mo: 0.25 mg/kg/hr (0.2 mL/kg/hr of a 0.125% solution or 0.4 mL/kg/hr of a 0.0625% solution)>18 mo: 0.3-0.375 mg/kg/hr (0.3 mL/kg/hr of a 0.125% solution or 0.6 mL/kg/hr of a 0.0625% solution

Ropivacaine : initial dose: Ropivacaine : 0.2% Dose: same regimen in mL/kg as for bupivacaine (see above)
Infusion : Same age-related infusion rates in mg/kg/hr as for bupivacaine (usual concentration of ropivacaine: 0.1%, 0.15%, or 0.2%)Do not infuse for more than 36 hr in infants < 3 ms

DOSING ACCORDING TO SEGMENT :

The volume of local anesthetic necessary for analgesia/anesthesia depends on location of surgery and epidural catheter. In young children the estimated volume would be: 0.04 mL/kg/segment. In children older than 10 years of age simple formula can be used: V (in mL) = 1/10 x (age in years).

TEST DOSE: The recommended test dose is 0.1mL/kg of local anesthetic with 5mcg/mL of epinephrine to maximum volume of 3mL (or 2.5 mcg/mL in the child less than 18 month old )