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RSUD KAB BKY

RSUD KABUPATEN BENGKAYANG

BIDANG ANESTESI

Anesthesia Medication Dosages

MEDICATION ADULT DOSE CHILD DOSE REMARKS
Atracurium Intubation: 0.3-0.5 Intubation: 0.3-0.5 Use with caution in
(nondepolarizing mg/kg mg/kg patients with asthma.
muscle relaxant) Maintenance: 0.1-0.2 Maintenance: 0.1-0.2
mg/kg mg/kg

Atropine 0.4 mg 0.02 mg/kg Minimum dose for child

(to decrease secretions) is 100 mcg. Max dose
for teen aged child is 1
mg.

Atropine 0.5 -1 mg 0.02 mg/kg Minimum dose for child

(for low heart rate) max dose 3 mg max dose child is is 100 mcg. Max dose
0.5 mg for teen aged child is 1
mg.

Atropine 0.015 mg/kg of atropine Same

(combined with given before or with
neostigmine neostigmine,
pyridostigmine pyridostigmine or
or edrophonium) edrophonium IV.

Butorphanol 0.5-2 mg IV or 1-4 mg Not recommended Do not use in patients

(non-opioid IM every 3-4 hours with coronary artery
agonist/antagonist) disease.
Do not use in patients
with opioid dependence.

Codeine 15-60 mg 0.5 – 1 mg/kg for Can be given every 4-6

(opioid analgesic) orally patients > 1 year old hours
(max dose is 60 mg)

Diazepam 2-10 mg 0.12-0.15 mg/kg for a Decrease the dose for

(sedation/anti-anxiety) child aged 6 months to the elderly.
11 years of age.

Diphenhydramine 25-50 mg or 0.3-0.5 0.5 mg/kg with a Use cautiously in

(anti-emetic) mg/kg intravenously maximum dose of 6.25 children. Never use in
mg in children 2-6 premature infants or
years; maximum dose of newborns.
12.5-25 mg in children
6-12 years.

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Droperidol 0.625 mg IVP Not recommended May cause abnormal
(anti-emetic) movements or
feelings of impending
doom. Treat with 25
mg diphenhydramine.
Do not use in patients
with Parkinson’s
disease.
May cause a serious
abnormal heart
rhythm.

Edrophonium 0.5-1 mg/kg of Same Maximum dose is 40

(reversal of edrophonium mg. Must be mixed
nondepolarizing (maximum dose is 40 with atropine or
muscle relaxants) mg of edrophonium) glycopyrrolate. Short
mixed with 0.015 mg/kg duration of action
of atropine or 0.01 may allow the non
mg/kg of glycopyrrolate depolarizing muscle
relaxant re-paralyze
the patient.

Ephedrine 5-20 mg intravenously. Not recommended Never use as a

(vasopressor) Titrate to effect. replacement for
Ephedrine may be given volume resuscitation.
intramuscularly in a
dose of 25-50 mg.

Epinephrine 0.5-1 mg 0.01 mg/kg

(cardiac arrest)

Fentanyl 2-10 mcg/kg IV 1-5 mcg/kg IV

(opioid analgesic)
Flumazenil 0.2 – 1 mg. 1 mg is the Not recommended Use with great caution
(reversal/antagonist maximum dose. Titrate in patients that have a
for benzodiazepines) slowly at a rate of 0.2 history of seizures or
mg per minute until the dependent on
desired effect is noted benzodiazepines.

Gallamine Intubation 1-1.5 mg/kg Same as adults Do not use in patients

(muscle relaxant) Maintenance: 0.1-0.75 with decreased renal
mg/kg function.

Glycopyrrolate 0.1-0.2 mg 4-6 mcg/kg

(to decrease secretions)

Glycopyrrolate 0.01 mg/kg of 0.01 mg/kg of

(reversal of glycopyrrolate given glycopyrrolate given
nondepolarizing before or with muscle before or with muscle
muscle relaxants) relaxant reversal. relaxant reversal.

Ibuprofen 400 mg orally 5-10 mg/kg orally Can be given every 6

(non-opioid analgesic) Hours

Ketamine 2 mg/kg 0.5-2 mg/kg Use atropine to decrease

(anesthetic) Secretions

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Meperidine/Pethidine 50-100 mg IV 1 – 1.5 mg/kg Decrease dose by half if
(opioid analgesic) 50-150 mg IM every 3 IM or IV every patient has been given
to 4 hours 3-4 hours promethazine. Decrease
dose in elderly and
those that weigh less
than 60 kg.

Methohexital Sedation: 0.25-1 mg/kg Same

(anesthetic induction) IV
Induction: 1-1.5 mg/kg
IV

Metoclopramide 5-10 mg 0.1 mg/kg less than 6 Given every 6-8 hours
(anti-emetic) years old. as needed.
2.5-5 mg 6 years to 14
years.

Midazolam Sedation: 1 mg IV every IV route: 6 months to 5 Oral dose should be

(sedation/ to reduce 2-3 minutes, titrated to years a dose of 0.05-0.1 mixed with a small
anxiety/ amnesia) effect mg/kg titrated to effect. amount (3-5 ml) of
(Max 6 mg) sweet clear juice or
6-12 years a dose of analgesic syrup to cover
0.05-0.1 mg/kg (Max 10 up bitter taste.
mg) Oral dose takes up to 30
Oral Route: 6 months minutes to be fully
and older 0.25- 0.5 effective.
mg/kg with max dose of Potent sedative, monitor
15-20 mg. patients for respiratory
depression and
hypotension.

Morphine 2.5-10 mg 0.03-0.05 mg/kg IM or Decrease dose by half if

(opioid analgesic) IM or IV IV every 3-8 hours. patient has been given
every 2-6 hours For children 6 promethazine. Decrease
months to 12 years. dose in elderly and
those that weigh less
than 60 kg.

Nalbuphine 5-10 mg IV, IM, or 10-100 mcg/kg IV, IM, Do not use in patients
(opioid subcutaneously. or subcutaneously. with a history of opioid
agonistantagonist) dependence.

Naloxone 0.1-.04 mg IV, IM, or 10-100 mcg/kg IV, IM, Antidote for opioids.
(opioid antidote) SC or SC May be given by IV,
IM, or SC
(subcutaneous) routes.
Repeat every 3-5
minutes until the patient
is responding and
breathing.

Neostigmine 0.05 mg/kg neostigmine Same dose as adult Reversal for

(reversal for (maximum of 5 mg) nondepolarizing muscle
nondepolarizing must be given with relaxants. Mix or give
muscle relaxants) atropine or the atropine or
glycopyrrolate glycopyrrolate first.
Neostigmine can cause
severe bradycardia if
given alone.

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Odansetron 4 mg intravenously 0.15 mg/kg
(anti-emetic)

Pancuronium Intubation: 0.04-0.08 Same dose as adult If you need to repeat the
(muscle relaxant) mg/kg dose give 0.01 mg/kg in
Maintenance: 0.01 adults and children.
mg/kg every 60 minutes

Pentazocine 20 mg IM or IV Not used in children Give every 2-4 hours as

(opioid needed.
agonistantagoinist)

Phenylephrine 50-100 mcg IV Not routinely used in Never use as a

(vasopressor) children replacement for volume
replacement. May
cause bradycardia in
patients who are
hypovolemic.

Promethazine 12.5-25 mg 0.25-0.50 mg/kg. Must If given IV, give slowly

(anti-emetic) be greater than 2 years. over 5 minutes. Same
Max dose is 25 mg. dose can be given IM.
Should be given every
4-6 hours as needed.

Propofol 2-2.5 mg/kg slowly 2.5-3.5 mg/kg slowly Give slowly over 30
(anesthetic induction) over 30 seconds for over 30 seconds for seconds.
induction of anesthesia. induction of anesthesia. May cause pain with
For maintenance of For maintenance of injection.
anesthesia a continuous anesthesia a continuous
infusion of 0.1-0.2 infusion of0.125-0.3
mg/kg/min or mg/kg/min.
alternatively
intermittent bolus of
20-50 mg.

Pyridostigmine 0.25 mg/kg of 0.25 mg/kg of Antidote for

(nondepolarizing pyridostigmine pyridostigmine nondepolarizing muscle
muscle relaxant (maximum dose is 30 (maximum dose is 30 relaxants. Mix or give the
reversal) mg of pyridostigmine) mg of pyridostigmine) atropine or glycopyrrolate
mixed with 0.015 mixed with 0.015 first. Pyridostigmine can
mg/kg of atropine or mg/kg of atropine or cause severe bradycardia
0.01 mg/kg of 0.01 mg/kg of if given alone.
glycopyrrolate. glycopyrrolate.

Rocuronium Intubation dose in Intubation dose in

(muscle relaxant) adults: 0.6-1.2 children: 0.4-1
mg/kg. mg/kg.
Maintenance of Maintenance of
blockade in adults blockade children:
and children: 0.06- 0.06-0.6 mg/kg.
0.6 mg/kg.

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Succinylcholine Intubation dose: 0.6-1.2 Intubation dose: Should not use more than
(depolarizing muscle mg/kg IV 1-1.5 mg/kg IV 150 mg.
relaxant) 2.5-4 mg IM dose. 2.5-4 mg IM dose. Many
contraindications…review
carefully.
Repeated doses close
together may cause
bradycardia or cardiac
arrest.

Thiopental Sodium 3-5 mg/kg Children: 5-6 mg/kg Use with caution in the
(anesthetic induction) Infants: 7-8 mg/kg elderly and dehydrated or
bleeding patients.

Vecuronium Intubation: 0.08-0.1 Same as adult dose

(muscle relaxant) mg/kg
Maintenance: 0.01-0.05
mg/kg

Resource: Daniel D. Moos.2004.Basic Guide to Anesthesia for Developing Countries.Vol 1. P.75.