Sedation of initially intubated & mechanically ventilated patients in ICU. Sedation of non-intubated patients prior to &/or during surgical & other procedures.
AdultICU sedation Loading infusion: 1 mcg/kg over 10 min, followed by maintenance infusion: 0.2-0.7 mcg/kg/hr. Procedural sedation Loading infusion: 1 mcg/kg over 10 min. Maintenance infusion: 0.6 mcg/kg/hr, then titrated to 0.2-1 mcg/kg/hr. Less invasive procedures eg, ophth surgery Loading infusion: 0.5 mcg/kg over 10 min. Maintenance infusion: 0.6 mcg/kg/hr, then titrated to 0.2-1 mcg/kg/hr. Awake fiberoptic intubation patient Loading infusion: 1 mcg/kg over 10 min. Maintenance infusion: 0.7 mcg/kg/hr. Elderly >65 yr Loading infusion: 0.5 mcg/kg over 10 min.
Not to be given as bolus dose. Not to be used as induction agent for intubation or sedative during use of muscle relaxant. Not suitable in patients requiring continuous deep sedation or w/ severe CV instability. Not recommended in malignant-hyperthermia sensitive patients. Preexisting bradycardia; hypotension, hypovolaemia, chronic hypotension or reduced functional reserve; impaired peripheral autonomic activity; ischaemic heart disease or severe cerebrovascular disease; severe neurological disorders. Monitor respiration in non-intubated patients. Transient HTN during loading dose. Avoid abrupt discontinuation. Concomitant use w/ other drugs w/ sedative or CV actions; anesth, sedatives, hypnotics, opioids. May affect ability to drive & use machines. Renal & severe hepatic impairment. Not recommended in women of childbearing potential & during pregnancy. Lactation. Paed patients. Elderly.
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