Table 6.
Drugs used in procedural sedation and analgesia
| Analgesics Class | Analgesics Name | Dose/Route | Peak | Duration |
|---|---|---|---|---|
| Opiates | Morphine | 0.1-0.2 mg/kg IV | 15 min | 2-4 hours |
| Fentanyl | 1-2 mcg/kg IV | 10 min | 30-60 min | |
| Sedatives | ||||
| Benzodiazepines | Midazolam | 0.02-0.1 mg/kg IV | 5 min | 1-2 hours |
| 0.2-0.5 mg/kg IN | 20-30 min | 60-90 min | ||
| 0.5-0.75 mg/kg PO | 20-30 min | 60-90 min | ||
| Barbiturates | Pentobarbital | 2-5 mg/kg PR(max 150 mg) | 15-60 min | 1-3 hours |
| 1-3 mg/kg IV (max 150 mg) | 1 min | 15 min | ||
| Hypnontics | Propofol | 1 mg/kg IV, then 0.5 mg/kg IV over 30-60 min | 6-7 min | 5-10 min |
| Etomidate | 0.1-0.2 mg/kg IV | 30 sec | 5-10 min | |
| Dissociative | ||||
| Ketamin | 1-2 mg/kg IV | 5 min | 30-60 min | |
| 3-5 mg/kg IM | 10 min | 1-2 hours | ||
| Adjuvants for ketamine | Atropine | 1 mg/kg IM/IV, min 0.1 mg (max 0.5 mg) | - | - |
| Midazolamk | 0.05mg/kg IV | - | - | |
| Inhaled | Nitrous Oxide | 30-50% N2O, mixed with O2 | 3-5 min | 5-10 min |
| Reversal agents | ||||
| Opioid reversal | Naloxone | <5yo or <2olbs:0.1 mg/kg IV/IM/SC/ET q2-3 min | 1-2 hours | - |
| >5yo or >20 lbs: 2 mg IV/IM/SC/ET q2-3 min | 1-2 hours | - | ||
| Benzodiazepine reversal | Flumazenil | 0.02 mg/kg IV q 1min (max 1 mg) | - | - |