Intravenous Anesthetics
Induction
mg/kg
Maintenance
g/kg/min
Sedation
g/kg/min
Propofol
1.5-2.5 100 - 250 50 - 200
Thiopental
3-5 50 - 100 30 70
Etomidate
0.2-0.4
Ketamine 1-2 (4-8
IM)
10 - 100 10 50
Methohexital
1-2
Midazolam
0.1-0.3 0.25 - 1
Fentanyl 5-20 g/kg 0.05 0.5
Sufentanil 2-10 g/kg 0.01 0.1
Anesthesia Reference Card
Neuromuscular Blocking Drugs
Intubating
dose mg/kg
Maintenance
mg/kg/min
ED
95
g
Succinylcholine 1-2
Rocuronium 0.6-1 10-15 300
Vecuronium 0.2 1-2 50
Cisatracurium 0.2 1-3 50
Mivacurium 0.3-0.4 5-15 80
Pancuronium 0.1 1-15 70
NMB Reversal
Cholinesterase Dose Anticholinergic Dose
mg/kg
rrolate 0.01
Edrophonium pine 0.0
Inhibitor
mg/kg
Neostigmine 0.05 Gycopy
0.5-1 Atro 2
at 10-13 l/hr (0.1 ml
Cardiovascular Drugs
Pressors CV Effects
Adrenergic
Activity
Bolus IV Infusion
g/kg/min
Duration
min
HR CO
SVR
Ind
Act
1
2
Phenylephrine 50-200
g
0.1-0.75 1-8 ~ ++ -
Ephedrine 5-20 mg 1-10 ++ ++ +
Dopamine dopa - 1 - 3 5-10 ~ ~ 0
3 10 + + ++
+ 10 - 20 ++ ++ +
Dobutamine - 2 - 20 5 ~ ~ 0 ++ +
Epinephrine 2-10 g 0.05-0.1 5-10 ~ + ++ ++
+ up to 1
mg
0.1 - 1 5-10 ++ ++ ++
Norepinephine - 0.05-0.5 1-10 ~ ++ ++
Isoproterinol 20-60 g 0.01-0.5 1-5 ++ ++
Beta Blockers
Esmolol 10-30 mg 50-300 5-10 - -
Labetalol 5-15 mg 2 5-90 ~ ~ - -
Metoprolol 2-15 mg 1-8
hr
- - -
Calcium Channel Blockers
Nicardipine 0.5-2 5-15
Nifedipine 10 mg SL 5-30
Diltiazem 5-20 mg
Verapamil 2.5-10
mg
2-60
Vasodilators
Nitroglycerine 50-100
g
0.2-10 1-5
Nitroprusside 50-100
g
0.2-10 1-10 ~
Hydralazine 5-10 mg 1-4
hr
~
Trimethaphan 1-20 mg 5-10
Inhaled Agents
MAC Blood:Gas
Coeff
Brain:Blood
Coeff
Vapor
Press
Desflurane 6-7 0.42 1.3 669
Sevoflurane 2 0.69 1.7 160
Isoflurane 1.2 1.5 1.6 240
Enflurane 1.6 1.9 1.5 172
Halothane 0.75 2.5 1.9 244
Nitrous Oxide 105 0.46 1.1
ETT Drugs
ALIEN V
2
Atropine
Lidocaine
Isoproterinol
Epinephrine
Naloxone
Vasopressin
Valium
Spinal Block units are mg or min Local Max Dose
T10 T6 T4 Duration Dur w/ epi Plain With Epi
Bupiv 6-10 8-14 12-20 90-120 120-150 150(2) 240(3)
Ropiv 6-10 8-14 12-16 90 140 200
Lido 25 50-75 75-100 45-60 60-90 300(4) 500(7)
Procain 75 125 200 30-45 60-75 500 600
Tetraca 6-10 8-14 12-20 60-90 120-180 100 200
Intrathecal
Proced PFMS
Pelvic 0.3-0.4
Hip/Knee/Abd 0.4-0.5
High Abd 0.5-0.6
Nephrec/CCX 0.6-0.7
AAA/Thorac 0.7-0.8
Pump in a bag/syringe
Sufenta 500mg +
Midaz 15mg + Roc 200mg
Mix in 500ml NS and run at
1ml/kg/hr
Sufenta 500mg +
Midaz 20mg + Roc 160mg
Mix in 50ml NS and infuse
m /kg/hr)
Misc
Flumazenil: 0.2 mg q 1 min to max 1mg
Dopram: 0.5-1.5 mg/kg q 5 min max 2mg/kg
Physostigmine: 0.5-1 mg q 15 min max 3 mg
PCA Dosing
Breakthrough
MS 1-2 mg q 20 min; 4 hr max 10 mg
Demerol 10-20 mg q 20 min; 4hr max 100 mg
Full Strength
MS 1-2 mg q 10 min; 4 hr max 30 mg
Demerol 10-20 mg q 10 min; 4hr max 300 mg
Narcan Dosing
For Respiratory Depression, N/V, Pruritis
Bolus: 0.08-0.2mg then infuse at 0.2-0.3 mg/hr
1.6 mg into 250 ml NS; run at 30-50 ml/hr
Parenteral Analgesia
Potency Peak
(min)
Duration
(hr)
Dose IV
(mg)
Morphine 1 5-20 2-4 1-10
Demerol 0.1 5-20 2-4 10-100
Dilaudid 7 5-20 2-4 0.5-2
Alfentanil 10 1-2 0.25 0.25-0.5
Fentanyl 100 5-10 0.5-1 25-100 g
Sufentanil
750 3-5 0.5-1 10-30 g
Remifent 250 1-2 0.2
Stadol 5 5-10 2-4 0.5-2
Toradol 9 (30mg) 30-60 3-7 30-60
Lumbar Epidural
Proced PFMS
Pelvic 4 mg
Abdom 6 mg
Thoracic 8 mg
Epidural Infusion
PFMS 20 mg + Bupiv 200 mg in 200 ml NS
Fentanyl 2 mg + Bupiv 200 mg in 200 ml NS
Pelvic-4 ml/hr, Abd-6 ml/hr, Thorac-8 ml/hr
Pediatric Anesthesia Reference Card
Pre-Op Meds
Drug Dose
Midazolam 0.5 mg/kg PO 15 mg max
0.2 mg/kg IM
0.02-0.1 mg/kg IV
Ketamine 3-6 mg/kg IM (induct)
Cimetadine 5-7.5 mg/kg PO
Clonidine 5 g/kg PO
Parenteral Analgesia
Drug Dose
Ketorolac
0.5-1 mg/kg
Butorphanol
5-10 g/kg, may repeat X2
Nalbuphine
0.1-0.3 mg/kg
Morphine
0.025-0.1 mg/kg
Meperidine
0.25-1 mg/kg
Opioid Maintenance
Agent Load g/kg Maint g/kg/hr
Fentanyl 2-10 3-10
Sufentanil 0.5-3 0.5-1
Alfentanil 50-250 25-150
Remifentanil 1 0.2-1 g/kg/min
Misc Meds
Drug Dose
Ondansetron
0.1-0.15 mg/kg
Flumazenil
10-30 g/kg
Naloxone
1-4 g/kg
Physostigmine
30 g/kg
Doxapram
0.5-1.5 mg/kg
Reglan
0.15 mg/kg PO
Droperidol
5-25 g/kg
Emergency Drugs
Drug Dose
Phenylephrine
1-10 g/kg
Epinephrine
10 g/kg
Ephedrine
0.1 mg/kg
Na Bicarb
0.3*Bdef*kg/2
Ca Gluconate
30-60 mg/kg
Adenosine
50-200 g/kg
Lidocaine
1 mg/kg
Esmolol
500 g/kg
Atropine
20 g/kg
Endotracheal Tube
Diameter
Age Diameter
Neonate 3 mm
4 mo 3.5 mm
12 mo 4 mm
> 1 yr 3.5 + Age/4
Lip to Mid-Trac. Dist
Wt/Age Length
1 kg 7 cm
2 kg 8 cm
3 kg 9 cm
6 mo 10 cm
12 mo 12 cm
>1 yr 12 + Age/2
LMA Sizing
Size Weight Cuff vol
1
<5 kg 3 ml
1.5
5-10 kg 7 ml
2
10-20 kg 10 ml
2.5
20-30 kg 14 ml
3
>30 kg 20 ml
NPO Guide
Age Reg feed Clears
Neonate
4 hr 2 hr
4-18 mo
6hr 3 hr
>18 mo
8 hr 3 hr
Est. Blood Vol.
Age Diameter
Neonate
85 ml/kg
1-4 yr
75 ml/kg
>5 yr
65 ml/kg
Allowable Blood Loss
0.8 * wt(kg) * (Htc-30)
Give 1 mg Ca per ml Blood
Caudal
Not+Loc
Proc Vol Local MS
Perineal
0.5 ml/kg
40g/kg
T10,
Hernia
0.75 ml/kg
50g/kg
T5,
Orchido
1 ml/kg
70g/kg
Riley ICU Anesthesia Reference Card
Pain & Sedation Options Acute Pain Service < 1 yr admit to ICU Staff Pagers
Dexmetedom 0.2-0.7 mcg/kg/hr PCA for >20 kg <6yrs consider intellect
Ketamine .25-.5 mg/kg/dose MSO
4
1 mg/cc
(Low range for strength p neurax MS) Bennie 212-1051
Fentanyl 2-3 mcg/kg/hr >5 ask staff Load dose .050-.15mg/kg
Emhardt 212-1060
MSO
4
25-50 mcg/kg/hr Inc dose 25-40 mcg/kg
Green 212-1063
MSO
4
.05-.1 mg/kg / q 2hr PRN lockout 10-20 min (5-99 possible)
Hardacker 212-1065
Stadol 5 30 mcg/kg/ q1 - 3 hr 4 hr max 150 mcg/kg (1
st
12 hr ) - 250 mcg/kg
Hillier 212-1069
Versed 20 50 mcg/kg q 1-2 hr PRN
avoid drips
Toradol .5mg/kg q 6 hr (max 30 mg)
5 days ?ortho OK?
Kelly
Krishna
212-7151
212-1071
Ativan 50 mcg/kg/dose q 4-6 hrs PRN Valium (muscle spasm) 2mg PO q 8hr X 48hr
Lathem 212-1052
Valium .05-.1 mg/kg/dose PO drugs Adjuncts to Pain Control
Mazurek 212-1096
Chloral
Hydrate
15-30mg/kg PO or PR q 8 hr
hypnotic 20-50 mg/kg
max dose 1gm 2gm/24 hr
Tylenol 3 Tylenol
Codeine
10-15mg/kg/dose
.5-1 mg/kg/dose
McNiece
Means
Presson
212-1075
212-1076
212-1081
Thorazine
Ketamine
.5mg/kg/dose ask staff
.25 - .5mg /kg /dose 30 60
Elixer Tylenol
Codeine
120 mg/tsp
12 mg/tsp (5cc)
Rao
Sheplock
212-1082
212-1084
Benadryl | .5mg/kg/dose
Consider hypoxia, hypercarbia, ptx, effusion,
hypoglycemia, hyponatremia,
Tablet Tylenol
Codeine
300mg
30 (10%)
Stasic
Stoelting
Tolley
212-1085
212-1086
212-1097
short term paralysis (staff approval)
Walker 212-1091
Respiratory Therapy Options Side Effect Therapy
Wolfe 212-1093
Albuterol neb .5% .5cc in 2.5 cc NS q 4-6 h Compazine >10kg >2yo .1mg PO,PR 6-8hr
Patti 274-9981
Racemic Epi 2.25% .5cc in 2.5 cc NS Reglan 60-100 mcg/kg
Other Numbers
Atrovent .02% .5mg in 2.5cc NS q 4-6 h Zofran .1-.15 mg/kg IV
Main OR 4-8222
NaHCO
3
4.2% str Newborn lavage q 4-6 h Benadryl 1mg/kg PO .5mg IV
PACU 4-9945
NaHCO
3
8.4% str Lavage q 4 6 h Valium (muscle spasm) 2mg PO q 8hr X 48hr
Workroom 4-9978
Mucomyst 5% - 10% q 6 h w/ventolin Naloxone IV 1 mcg/kg
Burn Unit 4-3927
Alupent .2 -.3 cc in 2 cc NS Naloxone gtt 5 mcg/kg/hr (6.4 mcg/cc)
ICU SE 4-6066
Heliox Tx 40% Hut Nubaine IV 50 mcg/kg /dose
ICU SW 4-0243
Normal Values
Age HR BP PaO2 Hb Wt (kg)
Preterm 150 50/30 70 18-22 <3
Neonate 140 60/40 70 18-22 3-4
6 month 135 85/60 85 12 7
1 year 130 90/60 85 11 10
4 year
100 95/65 90 13
(Age-1)*2
+ 10
Blood Gas Guide
Metabolic Acidosis pCO
2
falls by 1 1.5 fall in HCO
3
CO2 pH
Metabolic Alkylosis pCO
2
rises by .25 1 rise in HCO
3
CO2 pH
Acute Resp Acidosis HCO3 1 mEq for ea 10 mmHg in CO2
Chronic Resp Acidosis HCO3 3 mEq for ea 10 mmHg in CO2
pH dec 0.08
for ea 10mm
inc in pCO2
Acute Resp Alkylosis HCO3 2 mEq for ea 10 mmHg in CO2
Chronic Resp Alkylosis HCO3 5 mEq for ea 10 mmHg in CO2
pH inc 0.08
for ea 10mm
dec in pCO2
