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 continuous infusion (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 continuous infusion (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 continuous infusion (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 continuous infusion (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 continuous infusion (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 continuous infusion 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 continuous infusion 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 continuous infusion (range for maintenance 0.125–4 mcg/kg/min; Continuation as an analgesic into ICU: 1 mcg/kg/min continuous infusion (range 0.05–1 mcg/kg/min).
