Review Article

Sedation and Analgesia in Children with Developmental Disabilities and Neurologic Disorders

Table 1


AgentTypeRouteDosageSedation/Analgesia
Induction

ThiopentalBarbiturateIV3–8 mg/kg
Rectal15–25 mg/kg

PentobarbitalBarbiturateIV2–6 mg/kg (150 mg max)
Oral2–6 mg/kg

KetamineN-methyl-D-aspartate (NMDA) antagonistIV2–4 mg/kg0.5–1 mg/kg titrated to effect
IM3–7 mg/kg

PropofolHypnotic, AmnesticIV2–4 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)

EtomidateHypnotic, Carboxylated imidazole derivativeIV0.3–0.5 mg/kg

DexmedetomidineCentral Acting α-2 AgonistIVLoading Dose: 0.5–2 mcg/kg
Maintenance Infusion: 0.2–0.7 mcg/kg/hour

MorphineOpioidIVBolus: 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
OralInfants and Children 0.25–0.5 mg/kg

FentanylOpioidIV1–3 mcg/kgBolus: 0.5–1 mcg/kg
Infusion: 0.5–3 mcg/kg/hour
Oral10–15 mcg/kg
Intranasal1-2 mcg/kg

RemifentanilOpioidIV0.1–0.5 mcg/kg/min

MidazolamBenzodiazepineIV0.1-0.2 mg/kgBolus: 0.1-0.2 mg/kg
Infusion 0.1–0.3 mg/kg/hour
IM0.2–0.5 mg/kg
Oral0.2–1 mg/kg (max 10 mg)

IV: Intravenous, IM: Intramuscular.