Table 5.
Opioids: dosing for procedural pain and routes of administration
| Route | Oral dose | Oral dosing interval | IV increment dose (max dose) | Other routes |
|---|---|---|---|---|
| Tramadol | ||||
| • Child | 1–2 mg/kg | 6 hourly | 1mg/kg (100mg) | PR, dose as for IV |
| Morphine | SC, dose as for IV PR, dose as for oral | |||
| • Neonate | 80 mcg/kg | 4–6 hourly | 25 mcg/kg (50mcg) (careful incremental titration in neonates) | |
| • Infant 1 – 3 months | 80–100 mcg/kg | 4 hourly | 25 mcg/kg (100mcg) | |
| • Infant 3 – 12 months | 100–200 mcg/kg | 4 hourly | 50 mcg/kg (200mcg) | |
| • Child | 200–400 mcg/kg | 4 hourly | 50 mcg/kg (200mcg) | |
| Diamorphine | SC, dose as for IV | |||
| • Neonate | 10–25 mcg/kg | |||
| • Child (>1year) | 100–200 mcg/kg | 4 hourly | 25–100 mcg/kg | Intranasal: 100 mcg/kg (max 10mg) (max 10mg) in 0.2ml sterile water, instil into one nostril |
| Fentanyl | NA | 0.5–1.0 mcg/kg | ||
| • Child 2–18 years (weight 10kg+) | Transmucosal: Lozenge 15–20 mcg/kg, (max 400 mcg) | |||
IV - intravenous, Max - maximum, NA - not applicable, PR – rectal, IM – intramuscular, SC - subcutaneous