Sedation of intubated pt as anesthesia or during treatment in ICU
Preterm neonate(< 32 wk gestation): 0.03 mg/kg/h (0.5 mcg/kg/min) IV.
Term neonate ( = 32 wk gestation): 0.06 mg/kg/h (1 mcg/kg/min) IV.
Child: 0.05-0.2 mg/kg IV over 2-3 min, then IV infusion 0.06-0.12 mg/kg/h (1-2 mcg/kg/min). Titrate by 25% of infusion rate to obtain optimal sedation. For obese child, calculate dose based on ideal body wt.
Adult: 0.01-0.05 mg/kg IV over several min, repeat q 10-15 min until adequate sedation.Sedation maintenance: usual infusion rate 0.02-0.10 mg/kg/h (1-7 mg/h). Titrate to desired amount. Titrate by 25-50% of initial infusion rate to achieve optimal sedation. For child with cardiac or respiratory compromise, high-risk surgery pt, and pts who have received narcotics or other CNS depressants, consider lower doses.
Preoperative sedation
Adult < 60 yr: 0.07-0.08 mg/kg IM 1 h before surgery.
Preoperative or procedural sedation
(IM) Child: 0.1-0.15 mg/kg IM; up to 0.5 mg/kg in anxious pt.
(IV) Infant, child 6 month-5 yr: 0.05-0.1 mg/kg IV over 2-3 min. Give other doses in small increments after 2-3 min, up to 0.6 mg/kg. Max 6 mg.
Child 6-12 yr: 0.025-0.05 mg/kg IV over 2-3 min. Give other doses in small increments after 2-3 min, up to 0.4 mg/kg. Max 10 mg.
Child, adolescent 12-16 yr: Dose as adult. Max total dose 10 mg. (PO) Infant, child 6 month-5 yr, uncooperative pt: 0.25-1 mg/kg PO in 1 dose. Max 20 mg. Child 6-16 yr, cooperative pt: 0.25-0.5 mg/kg PO in 1 dose. Max 20 mg. For child with cardiac or respiratory compromise, highrisk surgery pt, and pts who have received narcotics or other CNS depressants, consider lower doses. For obese child, calculate dose based on ideal body wt. |