Initial Dose:

Solution

Intravenous (IV)

every 10 second

<55 years-ASA I/II:40mg Intravenous every 10 sec
Not premedicated with intramuscular opioids or benzodiazepines:2-2.5mg/kg Intravenous
>55 years-ASA III/IV: 20mg Intravenous every 10 sec
Maintenance Dose
<55 years-ASA I/II:0.1-0.2 mg/kg/min Intravenous
Intermittent bolus-Increase 2.5-5ml
>55 years-ASA III/IV:0.05-0.1 mg/kg/min Intravenous

300 - 350

mcg/kg

Solution

Intravenous (IV)

0.5 - mi

minute

Indicated for Anesthesia Induction
0.5-1 mcg/kg per minute IV; may be increased up to 1 mcg/kg per minute
Indicated for Anesthesia Maintenance
0.25-0.5 mcg/kg per minute; and for every 2-5 minutes 0.5-1 mcg/kg bolus in response to light anaesthesia
Indicated for Conscious Analgesia
1 mcg/kg IV bolus, followed by 0.05-0.2 mcg/kg per minute IV

indicated for Anesthetic, lubricant, and antiseptic prior to urologic procedure:

Prior urologic procedure
Males
Instill 6 to 11 ml intraurethral 10-12 mins before surgery

Females
Instill 6 ml intraurethral to full the urethra 10-12 mins before surgery

Indicated for spinal anesthesia:

For perineum:5mg/dose
For saddle block:2-5mg/dose
For spinal:1% diluted solution 1:1 in cerebrospinal fluid, administer 1 ml for 5 secs
High, median and low saddle:0.2%-0.3% solution
For lower extremities:10mg/dose
Prolonged-1% solution
Doses more than 15 mg should only be used in extreme circumstances

Indicated for general anesthesia:

0.2 - 0.6

mg/kg

Solution

Intravenous (IV)

30-60sec

0.4mg to 0.6mg intravenous, subcutaneous, or intramuscularly

Induction dose: Depending on the patient's reaction, an intravenous bolus of 50 to 120 mg (70 mg on average) at 10 mg (1 mL of 1% solution) over 5 seconds is used

Maintenance dose: 4-6 mg/min Intravenous drip or 20–40 mg (2 to 4 mL of 1% solution) Intravenous push every 4 to 7 minutes whenever necessary

Induction dose- 3% inhalation, initially. Every two to three breaths, increase by 0.5 to 1%
Maintenance dose-with or without nitrous oxide, 2.5 to 8.5%

Indicated for Local Dermal Analgesia:

Superficial dermatologic treatments
Patch- Apply the patch to healthy skin for 30 minutes before the treatment

IV cannulation or venipuncture
Patch- Before the treatment, apply the patch to healthy skin for 30 minutes

Topical Cream
Indicated for topical local analgesia during superficial dermatological treatments on adults with undamaged skin
Apply to healthy skin 20 to 30 minutes before superficial dermatological operations
Apply at least 60 minutes before laser tattoo removal or equivalent treatments

Peripheral Nerve Blocks
Dental: Administer 1 to 5ml of 2% solution (20 to 100mg of total dose)

Paravertebral- Administer 3 to 5ml of 1% solution (30 to 50mg of total dose)

Obstetrical paracervical analgesia- Administer 10 ml of 1% solution (100mg of total dose)

Brachial- Administer 15 to 20ml of 1.5% solution (225 to 300mg of total dose)

Intercostal-Administer 3ml of 1% solution (30 mg of total dose)

Pudendeal- Administer 10 ml of 1% solution (100mg of total dose)


Epidural/Central Nerve Blocks
Thoracic- Administer 20 to 30ml of 1% solution (200 to 300mg of total dose)


Lumbar Anesthesia- Administer 15 to 20ml of 1.5% solution (225 to 300mg of total dose) or 10 to 15ml of 2% solution (200 to 300mg of total dose)

General-Administer for anesthesia 2 to 3ml/dermatome

Lumbar Analgesia-Administer 25 to 30 ml of 1% solution (250 to 300mg of total dose)

Infiltration Anesthesia
Intravenous region: Administer 10 to 60 mL of 0.5% solution (50 to 300 mg of total dose)

Percutaneous: Administer 1 to 60 mL of 0.5-1% solution (5 to 300 mg of total dose)


Sympathetic Nerve Blocks
Lumbar: Administer 5 to 10 mL of 1% solution (50 to 100 mg total dose)
Cervical: Administer 5 mL of 1% solution (50 mg total dose)

Local Anesthetics:

prilocaine 4% solution or prilocaine combined with epinephrine, 40 to 80 mg (1-2 mL), for dental infiltration
Do not exceed (8 mg/kg) 600 mg in two hours

12 to 25 years
1.4% with 65% N2O/35% oxygen or 2.6% in oxygen

25 to 40 years
1.1% with 65% N2O/35% oxygen or 2.1% in oxygen

40 to 60 years
0.9% with 65% N2O/35% oxygen or 1.7% in oxygen

60 to 80 years
0.9% with 65% N2O/35% oxygen or 1.7% in oxygen

Dental Anesthesia:

Indicated for Regional anesthesia for Teeth 4-13 and A-J restoration
Administer 2 sprays intranasally 4 to 5 minutes apart
Apply to the inside of the nose on the same side as the maxillary tooth being treated.
Commence the dental procedure 10 minutes after the second spray has been applied.
If enough anesthesia is not attained 10 minutes after the second spray, provide one more spray (0.2 mL).

oral:

Dissolve 1 lozenge in the mouth slowly;
may repeat every two hours when necessary

Indicated for Anesthesia
General Anesthesia: 8-30 mcg/kg intravenously; after that, 25-30 mcg intravenously as needed
Intubation/Induction: 1-2 mcg/kg intravenously; after that, 10-50 mcg intravenously as needed
The dose should be ideally calculated depending on body weight with ventilatory support, it should generally be administered with 100 % oxygen
Low dose: Analgesia in ventilation (adjunct), intubation
High dose: Induction for Primary anesthesia and maintenance

Indicated for In Dental Procedures, Conductive, Infiltrative, or Local Anesthesia
Oral surgery: 1 ml to 5.1 ml injectable solution of 4%; total dose is 40-204 mg
Infiltration: 0.5 ml to 2.5 ml injectable solution of 4%; total dose is 20-100 mg
Nerve block: 0.5 ml to 3.4 ml injectable solution of 4%; total dose is 20-136 mg
It should not exceed 7 mg/kg (i.e., 0.175 mL/kg)

Indicated for Surgery Premedication
Administer a dose of 50-100 mcg via IM injection or slow IV infusion 30-60 min before the surgery.
As an adjunct to regional anesthesia, administer a slow IV infusion of 25-100 mcg over a period of 1-2 min.
General Anesthesia
For minor surgical procedures, administer an IV dose of 0.5-2 mcg /kg of body weight. For major surgeries, start with an initial dose of 2-20 mcg/kg of body weight, followed by a maintenance infusion of 1-2 mcg/kg of body weight per hour via IV route. Stop the infusion 30-60 minutes before the surgery ends and restrict the total amount of fentanyl doses to 10-15 mcg/ kg of body weight to enable rapid recovery and early removal of the breathing tube. fentanyl is rarely used as an adjunct to general anesthesia, but if required, administer an IV dose of 20-50 mcg/kg of body weight.
Analgesia as off-label
Administer a bolus IV dose of 1-2 mcg/kg of body weight or a dose of 25-100 mcg as needed or deliver a continuous IV infusion of 1-2 mcg/kg of body weight/hr, or 25-200 mcg/hr. In cases of severe pain, administer a dose of 50-100 mcg via IV or IM route every 1-2 hours as needed. Patients who have been previously exposed to opioids may tolerate higher initial doses.
For patient-controlled analgesia (PCA), use a concentration of 10 mcg/ml via IV route. The demand dose should be 20 mcg, with a lockout interval of 5-10 minutes, and a base rate of no more than 50 mcg per hour.

Indicated for Postsurgical Local Analgesia
In bunionectomy- 106 mg or 8 ml through surgical site infiltration once
Infiltrate 7 ml of the dose into the surrounding tissues during bone or ligament surgery
In hemorrhoidectomy- 266 mg or 20 ml through surgical site infiltration once
Dilute the 20 ml solution with 10 ml of saline to make up 30 ml of total
Divide the final solution into 6 aliquots of 5 ml each
Perform the anal sphincter visualization and infilter the aliquots with even numbers

Indicated for Reversal of Neuromuscular Blockers:

Adults having surgery may use a selective relaxant binding agent to reverse neuromuscular blockade (NMB) brought on by rocuronium or vecuronium.
Administer as a single intravenous bolus infusion into an existing intravenous line over 10 seconds.

For vecuronium and rocuronium
After vecuronium or rocuronium-induced neuromuscular blockade, a dosage of 4 mg/kg is advised if spontaneous recovery of the twitch response remains below 1 to 2 post-tetanic counts (PTC) or if there are no twitching responses to train-of-four (TOF) stimulation.
After vecuronium or rocuronium-induced neuromuscular blockade, a dosage of 2 mg/kg is advised if spontaneous recovery has progressed to the re-emergence of the following twitch (T2) in response to TOF stimulation.

For rocuronium only
If reversing neuromuscular blockade is clinically necessary and must be done quickly (within 3 minutes), 16 mg/kg of rocuronium is administered.
The effectiveness of the 16-mg/kg dosage given after vecuronium administration has yet to be investigated.

Indicated for surgical anesthesia
Intrathecal- Administer 3 mL of solution containing 0.5% concentration
Epidural-Cesarean: Administer 0.5% solution within the range of 15-30 mL, with a maximum solitary dose of 150 mg
Surgery (not cesarean): Administer 10-20 mL of a solution containing 0.5%- 0.75% , with a maximum solitary dose of 150 mg
Extended surgical procedures could necessitate a maximum total dosage of 400 mg within a 24-hours
Dental- Administer 5 to 10 mL of a solution with a concentration between 0.5% -0.75%
Local infiltration-Administer 1-60 mL of a solution with 0.25 % concentration, with a maximum dosage not exceeding 150 mg (peribulbar block)
Ophthalmic- Administer 5-15 ml of a solution with 0.75 % concentration
Peripheral nerve-Administer 1-40 ml of a solution with 0.25% concentration or 1-30 ml of a solution with a 0.5% concentration with a maximum dosage not exceeding 150 mg

For tonometry:
Put one drop into the conjunctival sac 1 min prior to measurement
For removal of foreign body:
Put three drops at 90 sec interval
For pterygium surgery:
Put one drop every 60 seconds for 10 doses

Initial Dose:

3-16 years-ASA I/II:2.5-3.5 mg/kg Intravenous for 20-30 sec
<3 years-not recommended
Maintenance dose
2 months-16 years-ASA I/II:0.125-0.3mg/kg/min

2

Solution

Intravenous (IV)

50 - 150

mcg/kg

Solution

Intravenous (IV)

20 - 30

minutes

Indicated for Maintenance:

Age: 2 months
0.4 mcg/kg per minute IV with Nitrous Oxide
Age: 1-12 years
0.25 mcg/kg per minute IV halothane, sevoflurane, & isoflurane
0.05-1.3 mcg/kg per minute IV, with a supplemental dose of 1 mcg/kg given over 30-60 secs IV

Anaesthetic
:

Prior urologic procedure
<12 years:6mg/kg-maximum dose
>12 years:4 doses of 6mg/kg in 24 hours

Indicated for general anesthesia:

<10 years: Safety and efficacy not established
>10 years: 0.2-0.6 mg/kg intravenous for 30-60sec

<12 years: Not recommended
Dose should be decreased by 30% in infants <6 months
≥12 years
Local infiltration: 0.25% and may increase up to 2.5 mg/kg

>1 month old:
Administer 6.6-10 mg/kg intramuscularly as a 5% solution (50 mg/mL) OR
Administer 25 mg/kg rectally as a 1% solution (10 mg/mL)

Indicated for the maintenance of anesthesia in babies and children who are tracheal intubated after desflurane-free induction:

Maintenance dose- with or without nitrous oxide, 5.2% to 10%

Indicated for the maintenance of anesthesia in babies and children who are tracheal intubated after desflurane-free induction:

Maintenance dose- with or without nitrous oxide, 5.2% to 10%

Indicated for Infiltration Anesthesia :

Intravenous region: Administer 3mg/kg
Percutaneous: Administer a maximum dose of 4 to 4.5mg/kg

Local Anesthetics:

<10 years: Dental infiltration: 40 mg of a 4% solution in a 1 mL dose. Do not exceed 8 mg/kg in 2 hours
More than 10 years:
Dental infiltration: 40 to 80 mg (1 to 2 mL) of prilocaine in combination or prilocaine with epinephrine in a 4% solution.
Do not exceed 600 mg (8 mg/kg) in a two-hour period.

0 to 1-month full-term neonate
3.3% in oxygen

1 to 6 months
3% in oxygen

Six months to <3 years
2% with 65% N2O/35% oxygen or 2.8% in oxygen

3 to 12 years
2% in oxygen or 2% in a mixture of 65% N2O and 3% oxygen

12 to 25 years
1.4% with 65% N2O/35% oxygen or 2.6% in oxygen

Dental Anesthesia:

Indicated for Regional anesthesia for Teeth 4-13 and A-J restoration
Administer 2 sprays intranasally 4 to 5 minutes apart
Apply to the inside of the nose on the same side as the maxillary tooth being treated.
The dental procedure may begin ten minutes shortly after the second spray.

oral:

Below 5 years: Safety & efficacy were not established
Above 5 years: Dissolve 1 lozenge in the mouth slowly; may repeat every two hours when necessary

Indicated for Anesthesia
Age >12 years
8-30 mcg/kg intravenously; after that, 25-30 mcg intravenously as needed
Age 2-12 years
10-25 mcg/kg Intravenously increments
Age <2 years
Safety and efficacy not established

Indicated for In Dental Procedures, Conductive, Infiltrative, or Local Anesthesia
Age 4-16 years
For safe and simple procedures, use a low dose range, 0.76-5.65 mg/kg
For complex procedures, 0.37-7.48 mg/kg
It should not exceed 7 mg/kg (i.e., 0.175 mL/kg)
Age <4 years
Safety and efficacy not established

Indicated for Surgery Premedication as off-label
For patients aged 1-12 years, administer an IV dose of 0.5-2 mcg/kg of body weight 3 minutes before the procedure. The dose can be repeated every 1-2 hours as needed.
For patients over 12 years of age, administer an IV dose of 0.5-2 mcg/kg of body weight per dose, not exceeding 50 mcg/dose, 3 minutes prior to the procedure. If necessary, the dose can be repeated after 5 minutes. If more than two doses are needed, the dose can be repeated up to 5 times, with a maximum dose of 25 mcg/dose.
Continuous Sedation or Analgesia
Administer a continuous IV infusion of 0.5-2 mcg /kg of body weight/hr and titrate the dose to achieve the desired effect.
Adjunct Anesthesia
Age < 2years: safety and efficacy of this medication have not been established.
Age > 2years: Administer a dose of 2-3 mcg/kg of body weight via IV or IM route every 1-2 hours as needed.

For <6 years- safety and efficacy are not seen
For >6 years- 4 mg/kg once through surgical site infiltration
Do not exceed a dose of more than 266 mg

Indicated for Reversal of Neuromuscular Blockers:

Adults having surgery may use a selective relaxant binding agent to reverse neuromuscular blockade (NMB) brought on by rocuronium or vecuronium.
Administer as a single intravenous bolus infusion into an existing intravenous line over 10 seconds.

For vecuronium and rocuronium
≥2 years:
After vecuronium or rocuronium-induced neuromuscular blockade, a dosage of 4 mg/kg is advised if spontaneous recovery of the twitch response remains below 1 to 2 post-tetanic counts (PTC) or if there are no twitching responses to train-of-four (TOF) stimulation.
After vecuronium or rocuronium-induced neuromuscular blockade, a dosage of 2 mg/kg is advised if spontaneous recovery has progressed to the re-emergence of the following twitch (T2) in response to TOF stimulation.
<2 years: Safety and efficacy not established.

For rocuronium only
If reversing neuromuscular blockade is clinically necessary and must be done quickly (within 3 minutes), 16 mg/kg of rocuronium is administered.

Indicated for surgical anesthesia
Local infiltration (iliohypogastric block/ Ilioinguinal) For children age greater than 6 months- less than 12 years
Administer 0.5 mL/kg/side solution with a concentration of 0.25%
The maximum dosage not to exceed 1.25 mg/kg/side
Administer 0.25 mL/kg/side solution with a concentration of 0.5%
The maximum dosage not to exceed 1.25 mg/kg/side

For tonometry:
Put one drop into the conjunctival sac 1 min prior to measurement
For removal of foreign body:
Put three drops at 90 sec interval
For pterygium surgery:
Put one drop every 60 seconds for 10 doses