Low Dose — 2 mcg/kg (0.002 mg/kg) (0.04 mL/kg).
For use in minor, but painful, surgical procedures.
May also provide some pain relief in the immediate postoperative period. | Moderate Dose — 2 to 20 mcg/kg (0.002 to 0.02 mg/kg) (0.04 to 0.4 mL/kg). For use in more major surgical procedures, in addition to adequate analgesia, may abolish some of the stress response.
Expect respiratory depression requiring artificial ventilation during anesthesia and careful observation of ventilation postoperatively is essential. | High Dose — 20 to 50 mcg/kg (0.02 to 0.05 mg/kg) (0.4 to 1 mL/kg).
For open heart surgery and certain more complicated neurosurgical and orthopedic procedures where surgery is more prolonged, and the stress response to surgery would be detrimental to the well-being of the patient. In conjunction with nitrous oxide/oxygen has been shown to attenuate the stress response as defined by increased levels of circulating growth hormone, catecholamine, ADH and prolactin.
Expect the need for postoperative ventilation and observation due to extended postoperative respiratory depression. |
Low Dose — 2 mcg/kg (0.002 mg/kg) (0.04 mL/kg).
Additional dosages infrequently needed in these minor procedures. | Moderate Dose — 2 to 20 mcg/kg (0.002 to 0.02 mg/kg) (0.04 to 0.4 mL/kg) - 25 to 100 mcg (0.025 to 0.1 mg) (0.5 to 2 mL)
Administer intravenously or intramuscularly as needed when movement and/or changes in vital signs indicate surgical stress or lightening of analgesia. | High Dose — 20 to 50 mcg/kg (0.02 to 0.05 mg/kg) (0.4 to 1 mL/kg). From 25 mcg (0.025 mg) (0.5 mL) to one half the initial loading dose as needed based on vital sign changes indicative of stress and lightening of analgesia.
Individualize the dosage especially if the anticipated remaining operative time is short. |