Trofentyl Dosage/Direction for Use

Route of administration: Intravenous administration either as a bolus or by infusion.
Intramuscular administration.
Fentanyl should be given only in an environment where airway can be controlled and by personnel who can control the airway.
To avoid bradycardia, it is recommended to administer a small intravenous dose of an anti-cholinergic just before anaesthetic induction.
Dosage: The dosage of Fentanyl should be individualized according to age, body weight, physical status, underlying pathological condition, use of other drugs, and type of surgery and anesthesia.
To avoid bradycardia, it is recommended to administer a small intravenous dose of an anti-cholinergic just before induction.
Use as an analgesic supplement to general anesthesia: Low dose: 2 μg/kg. Fentanyl in small doses is most useful for minor, but painful, surgery.
Moderate dose: 2-20 μg/kg. Where surgery becomes more complicated, a larger dose will be required. The duration of activity is dependent on dosage.
High dose: 20-50 μg/kg. During major surgical procedures, in which surgery is longer, and during which the stress response would be detrimental to the well-being of the patient, dosages of 20-50 μg/kg of Fentanyl with nitrous oxide/oxygen have been shown to have an attenuating effect.
When dosages in this range have been used during surgery, post-operative ventilation and observation are essential in view of the possibility of extended post-operative respiratory depression. Supplemental doses of 25-250 μg (0.5-5 ml) should be tailored to the needs of the patient and to the anticipated time until completion of the operation.
Use as an anesthetic agent: When attenuation of the response to surgical stress is especially important, doses of 50-100 μg/kg may be administered with oxygen and a muscle relaxant. This technique provides anaesthesia without necessitating the use of additional anaesthetic agents. In certain cases, doses up to 150 μg/kg may be required to produce this anaesthetic effect.
Fentanyl has been used in this fashion for open heart surgery and certain other major surgical procedures in patients for whom protection of the myocardium from excess oxygen demand is particularly indicated.
Elderly (65 years of age and older): The initial dose should be reduced in the elderly and in debilitated patients. The effect of the initial dose should be taken into account in determining supplemental doses. As with other opioids, the dose should be reduced in elderly or debilitated patients.
Pediatrics: For induction and maintenance in children aged 2-12 years, a dose of 2-3 μg/kg is recommended.