Induction of Anesthesia
- IV (Adults): 0.5–1 mcg/kg/min continuous infusion (an initial dose of 1 mcg/kg may be given over 30–60 sec).
Maintenance of Anesthesia
- IV (Adults): With nitrous oxide 66% — 0.4 mcg/kg/min (range 0.1–2 mcg/kg/min); with isoflurane (0.4–1.5 MAC) or propofol (100–200 mcg/kg/min) — 0.25 mcg/kg/min (range 0.05–2 mcg/kg/min). Supplemental bolus doses of 1 mcg/kg may be given.
- IV (Children 1–12 yr): With halothane 0.3–1.5 MAC, sevoflurane 0.3–1.5 MAC or isoflurane 0.4–1.5 MAC — 0.25 mcg/kg/min (range 0.05–1.3 mcg/kg/min); supplemental doses of 1 mcg/kg may be given.
- IV (Infants birth-2 mo): With nitrous oxide 70% — 0.4 mcg/kg/min (range 0.4–1 mcg/kg/min); supplemental doses of 1 mcg/kg may be given.
Continuation as an Analgesic in Immediately Postoperative Period
- IV (Adults): 0.1 mcg/kg/min (range 0.025–0.2 mcg/kg/min).
Monitored Anesthesia Care (Remifentanil Alone)
- IV (Adults): Single IV dose — 1 mcg/kg given 90 sec before local anesthetic orcontinuous infusion — 0.1 mcg/kg/min beginning 5 min before local anesthetic, then 0.05 mcg/kg/min after local anesthetic (range 0.025–0.2 mcg/kg/min).
Monitored Anesthesia Care (Remifentanil + Midazolam)
- IV (Adults
2 yr): Single IV dose — 0.5 mcg/kg given 90 sec before local anesthetic orcontinuous infusion — 0.05 mcg/kg/min beginning 5 min before local anesthetic, then 0.025 mcg/kg/min after local anesthetic (range 0.025–0.2 mcg/kg/min).
Coronary Artery Bypass Surgery
- IV (Adults): Induction and maintenance of anesthesia — 1 mcg/kg/min (range for maintenance 0.125–4 mcg/kg/min; continuation as an analgesic into ICU — 1 mcg/kg/min (range 0.05–1 mcg/kg/min).
