Induction of general anesth Adult <55 yr 40 mg every 10 sec until induction onset (2-2.5 mg/kg);
elderly, debilitated or ASA-PS III or IV patients 20 mg every 10 sec until induction onset (1-1.5 mg/kg);
cardiac anesth 20 mg every 10 sec until induction onset (0.5-1.5 mg/kg);
neurosurgical patients 20 mg every 10 secs until induction onset (1-2 mg/kg);
ped 3-16 yr 2.5-3.5 mg/kg administered over 20-30 sec.
Maintenance of general anesth Adult <55 yr 100-200 mcg/kg/min (6-12 mg/kg/hr);
elderly, debilitated or ASA-PS III or IV patients 50-100 mcg/kg/min (3-6 mg/kg);
cardiac anesth in primary HYPRO w/ secondary opioid 100-150 mcg/kg/min;
cardiac anesth in low dose HYPRO w/ primary opioid 50-100 mcg/kg/min.
Ped 2 mth to 16 yr 125-300 mcg/kg/min (7.5-18 mg/kg/hr) following the 1st ½ hr of maintenance, if clinical signs of light anesth are not present, infusion rate should be decreased.
Intermittent bolus Maintenance of general anesth Adult <55 yr Increments of 20-50 mg as needed.
Initiation of MAC sedation Adult <55 yr 100-150 mcg/kg/min (6- 9 mg/kg/hr) for 3-5 min or slow inj of 0.5 mg/kg over 3-5 min followed immediately by maintenance infusion.
Maintenance of MAC sedation Adult <55 yr 25-75 mcg/kg/min (1.5-4.5 mg/kg/hr) or incremental bolus doses of 10 mg or 20 mg.
Initiation & maintenance of ICU sedation in intubated, mechanically ventilated Adult Initial infusion 5 mcg/kg/min (0.3 mg/kg/hr) for at least 5 min. Subsequent increments of 5-10 mcg/kg/min (0.3-0.6 mg/kg/hr) over 5-10 min. Maintenance: 5-50 mcg/kg/min (0.3-3 mg/kg/hr) or higher.
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