CONSCIOUS SEDATION, BY SLOW INTRAVENOUS INJECTION (APPROX. 2 MG/MINUTE) 5 - 10 MINUTES BEFORE PROCEDURE, INITIALLY 2 - 2.5 MG (ELDERLY 0.5 - 1 MG), INCREASED IF NECESSARY IN STEPS OF 1 MG (ELDERLY 0.5 - 1 MG); USUAL TOTAL DOSE 3.5 - 5 MG (MAX. 7.5 MG), ELDERLY MAX. 3.5 MG; CHILD BY INTRAVENOUS INJECTION OVER 2 - 3 MINUTES, 6 MONTHS - 5 YEARS INITIALLY 50 - 100 MICROGRAMS/KG, DOSE INCREASED IF NECESSARY IN SMALL STEPS (MAX. TOTAL DOSE 6 MG), 6 - 12 YEARS INITIALLY 25 - 50 MICROGRAMS/KG, DOSE INCREASED IF NECESSARY IN SMALL STEPS (MAX. TOTAL DOSE 10 MG)
BY INTRAMUSCULAR INJECTION, CHILD 1 - 15 YEARS 50 - 150 MICROGRAMS/KG; MAX. 10 MG
SEDATIVE IN COMBINED ANAESTHESIA, BY INTRAVENOUS INJECTION, 30 - 100 MICROGRAMS/KG REPEATED AS REQUIRED OR BY CONTINUOUS INTRAVENOUS INFUSION, 30 - 100 MICROGRAMS/KG/HOUR (ELDERLY LOWER DOSES NEEDED); CHILD NOT RECOMMENDED
PREMEDICATION, BY DEEP INTRAMUSCULAR INJECTION, 70 - 100 MICROGRAMS/KG (ELDERLY AND DEBILITATED 25 - 50 MICROGRAMS/KG) 20 - 60 MINUTES BEFORE INDUCTION; CHILD 1 - 15 YEARS 80 - 200 MICROGRAMS/KG
INDUCTION (BUT RARELY USED), BY SLOW INTRAVENOUS INJECTION, 150 - 200 MICROGRAMS/KG (ELDERLY AND DEBILITATED 100 - 200 MICROGRAMS/KG) GIVEN IN DIVIDED DOSES (MAX. 5 MG) AT INTERVALS OF 2 MINUTES; MAX. TOTAL DOSE 600 MICROGRAMS/KG; CHILD 7 - 18 YEARS 150 MICROGRAMS/KG (MAX. 7.5 MG) GIVEN IN STEPS OF 50 MICROGRAMS/KG (MAX. 2.5 MG) OVER 2 - 5 MINUTES; WAIT FOR 2 - 5 MINUTES THEN GIVE ADDITIONAL DOSES OF 50 MICROGRAMS/KG (MAX. 2.5 MG) EVERY 2 MINUTES IF NECESSARY; MAX. TOTAL DOSE 500 MICROGRAMS/KG (NOT EXCEEDING 25 MG)
SEDATION OF PATIENTS RECEIVING INTENSIVE CARE, BY SLOW INTRAVENOUS INJECTION, INITIALLY 30 - 300 MICROGRAMS/KG GIVEN IN STEPS OF 1 - 2.5 MG EVERY 2 MINUTES, THEN BY SLOW INTRAVENOUS INJECTION OR BY CONTINUOUS INTRAVENOUS INFUSION, 30 - 200 MICROGRAMS/KG/HOUR; REDUCE DOSE (OR REDUCE OR OMIT INITIAL DOSE) IN HYPOVOLAEMIA, VASOCONSTRICTION, OR HYPOTHERMIA; LOWER DOSES MAY BE ADEQUATE IF OPIOID ANALGESIC ALSO USED; NEONATE UNDER 32 WEEKS GESTATIONAL AGE BY CONTINUOUS INTRAVENOUS INFUSION, 30 MICROGRAMS/KG/HOUR, NEONATE OVER 32 WEEKS GESTATIONAL AGE AND CHILD UNDER 6 MONTHS 60 MICROGRAMS/KG/HOUR, CHILD OVER 6 MONTHS BY SLOW INTRAVENOUS INJECTION, INITIALLY 50 - 200 MICROGRAMS/KG, THEN BY CONTINUOUS INTRAVENOUS INFUSION, 60 - 120 MICROGRAMS/KG/HOUR, ADJUSTED ACCORDING TO RESPONSE