Review Article
Sedation and Analgesia in Children with Developmental Disabilities and Neurologic Disorders
| Agent | Type | Route | Dosage | Sedation/Analgesia | Induction |
| Thiopental | Barbiturate | IV | 3–8 mg/kg | | Rectal | 15–25 mg/kg | |
| Pentobarbital | Barbiturate | IV | | 2–6 mg/kg (150 mg max) | Oral | | 2–6 mg/kg |
| Ketamine | N-methyl-D-aspartate (NMDA) antagonist | IV | 2–4 mg/kg | 0.5–1 mg/kg titrated to effect | IM | | 3–7 mg/kg |
| Propofol | Hypnotic, Amnestic | IV | 2–4 mg/kg (Lower dose for critically ill) | Initial: 200–300 mcg/kg/min | Maintenance Infusion: 125–200 mcg/kg/min (Infants/younger children may require higher dosages) |
| Etomidate | Hypnotic, Carboxylated imidazole derivative | IV | 0.3–0.5 mg/kg | |
| Dexmedetomidine | Central Acting α-2 Agonist | IV | | Loading Dose: 0.5–2 mcg/kg | | Maintenance Infusion: 0.2–0.7 mcg/kg/hour |
| Morphine | Opioid | IV | | Bolus: Neonate 25–50 mcg/kg | | | Infants and Children 15–30 mcg/kg | | | Infusion: Neonate 2–10 mcg/kg/hour | | | Infants and Children 15–30 mcg/kg/hour | Oral | | Infants and Children 0.25–0.5 mg/kg |
| Fentanyl | Opioid | IV | 1–3 mcg/kg | Bolus: 0.5–1 mcg/kg | | | Infusion: 0.5–3 mcg/kg/hour | Oral | | 10–15 mcg/kg | Intranasal | | 1-2 mcg/kg |
| Remifentanil | Opioid | IV | | 0.1–0.5 mcg/kg/min |
| Midazolam | Benzodiazepine | IV | 0.1-0.2 mg/kg | Bolus: 0.1-0.2 mg/kg | | | Infusion 0.1–0.3 mg/kg/hour | IM | | 0.2–0.5 mg/kg | Oral | | 0.2–1 mg/kg (max 10 mg) |
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IV: Intravenous, IM: Intramuscular.
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