Author:
Kai Knudsen
Updated:
21 August, 2024
Here, you will find medications for pediatric anesthesia and pediatric intensive care. There is a medication calculator to quickly find the correct dosages of the drugs commonly used in pediatric anesthesia. Dosages for parenteral medications for children, such as antibiotics and analgesics, are also provided.
- Common Parenteral Medications for Children
- Dosage of Infusions for Children
- Calculate Correct Medicine Doses
- Max Doses of Local Anesthetics for Children
- Common Parenteral Antibiotics for Children
- Morphine and Other Strong Analgesics for Children
- ePed – Drug Information for Patients Under 18 Years
- Antiemetics for Children
- Dexmedetomidine
- Premedication with Intranasal Sufentanil for Children
- Inhalation of Racemic Adrenaline (Racepinephrine)
- Steroid Schedule for Children
Common Parenteral Medications for Children
Recommended Dosage of Parenteral Medications for Children
| Medication | Concentration | Dose |
|---|---|---|
| Actrapid (short acting insulin human) | 1 E/ml | 0.05-0.1 E/kg |
| Adenosine | 1 mg/ml | 100 μg/kg, increased by 50 μg/kg for each dose, step up to 300 μg/kg. Quick flush. Preferred in CVC. |
| Epinephrine (Adrenalin) | 0,1 mg/ml | For anaphylaxis: 1-2 μg/kg. At heart stop: 10 μg/kg |
| Atropine | 0,5 mg/ml | 10 μg/kg. Max 0,5 mg/dose. |
| Epinephrine by inhalation | 1 mg/ml | <1 year 1 mg <2 years 2 mg ATTENTION! Not directly in the tube |
| Ipratropium (Atrovent) | 0.25 mg/ml | <6 years 0.4-1 ml x 4 6-12 years 1 ml x 4 >12 years 2 ml x 4 |
| Betametasone (Betapred) | 4 mg/ml | 0,2 mg/kg. Max dose: PONV 4 mg Max dose: anafylaxia 8 mg |
| Calcium gluconate | 0,5 ml/kg | Max 10 ml/dose. |
| Parecoxib (Dynastat) | 20 mg/ml | 0.5 mg/kg x 1-2. Max 40 mg/dose |
| Fenobarbital | 20 mg/ml | 5 mg/kg. Max x 3/day |
| Fentanyl | 50 μg/ml | 1-2 μg/kg |
| Furosemide | 10 mg/ml | 0,1-0,5 mg/kg |
| Clonidine | 15 μg/ml | 1-2 μg/kg x 3-6/day |
| Midazolam | 1 mg/ml | 0,05-0,1 mg/kg |
| Morphine | 1 mg/ml | 0,05-1 mg/kg |
| Naloxone | 0,02 mg/ml | 10 μg/kg (adult 0.1-0.2 mg) Repeat as needed at 2 min intervals |
| Nimodipin (Nimotop) | 200 μg/ml | 20-30 μg/kg/h |
| Esomeprazole (Nexium) | 8 mg/ml | 0,5 mg/kg x 2 |
| Ondansetrone | 2 mg/ml | 0,1 mg/kg. Max x 4/day |
| Paracetamol | 10 mg/ml | <1 year or 10 kg: 7.5 mg/kg >1 year: 15 mg/kg. Max x 4 / day |
| Thiopentone (Pentothal) | 25 mg/ml | 2-5 mg/kg in case of ICP increase |
| Phenergan | 25 mg/ml | 0.2-0.5 mg/kg. Max 12.5 mg/dos |
| Hydrocortisone (Solu-Cortef) | 50 mg/ml | 5 mg/kg. Max 100 mg/dose. |
| Diazepam (Stesolid) | 5 mg/ml | 0,2-0,3 mg/kg |
| Klemastine (Tavegyl) | 1 mg/ml | 0,05 mg/kg. Max x 2/day. Slow infusion. |
| Sodium Bicarbonate (Tribonat) | 0,5 mmol/ml | Weight x BE x 0.3 = mmol buffer. Start giving half the amount. At heart stop: 2 mmol/kg |
| Budesonide (Pulmicort) | 0,25 mg/ml | 0,25 mg x 2 |
| Salbutamol (Ventoline) | 1 mg/ml or 5 mg/ml | 0,15 mg/kg x 4 – 6 (max x 24) Max 5 mg/dose. |
| Clemastin (Tavegyl) | 1 mg/ml | 0.05 mg/kg. Max x 2/day. Give slowly |
| Micronefrin-Racepinephrine | Racepinephrine conc: 22,5 mg/ml | 0,05 ml/kg/dose (max 0,75 ml/dose) <5 kg 0,25 ml |
| Remember to pull up drugs in as small syringes as possible! If the dose is <0.5 ml then pull into 1 ml syringe | ||
| These are no general ordinances but rather an aid in the work with children. All medicines must be prescribed in writing on the daily record by name, strength and amount. | ||
the daily journal with name, strength and quantity
Dosage of Infusions for Children
Infusions for children
| Medications | Concentration | Infusion Dose | Other |
|---|---|---|---|
| Actrapid | 1 E/ml | 0.025-0.1 E/kg/h | |
| Adrenaline (Epinephrine) | 20 μg/ml | 20-300-(500) nanog/kg/min | Administered in a central venous catheter (CVC) |
| Amiodarone (Cordarone) | 15 mg/ml | Optional loading dose of 5 mg/kg given over 1-4 hours. Maintenance dose 10-20 nanograms/kg/min. | Max 1200 mg/24 h Total treatment dose 100 mg/kg |
| Dexmedetomidine (Dexdor) | 4 or 8 µg/ml | 0.3-1.4 µg/kg/h (start 0.7) | No bolus dose given |
| Dopamine | 2 mg/ml | 2.5-20 µg/kg/min | Administered in a CVC |
| Esketamine (Ketanest) | 1 mg/ml | 0.1-0.25-(0.6) mg/kg/h | Not for children <1 month |
| Phenylephrine | 0.1 mg/ml | 0.1-0.5 µg/kg/min | |
| Furosemide | 10 mg/ml | 0.5-1 mg/kg/h (start 0.5) | |
| Hypertonic NaCl (3%) | 500 ml Nacl+40 ml Addex Na 4 mmol/ml | 3-5 ml/kg over 20-30 min | Max 250 ml |
| Isoprenaline | 10 µg/ml | 0.02-1 µg/kg/min | Start with the lowest dose |
| Potassium Chloride | 1 mmol/ml | 0.1-0.4 mmol/kg/h | Max 15 mmol/h. |
| Clonidine | 15 μg/ml | 0.5-2 µg/kg/h | |
| Mannitol | 150 mg/ml | 5 ml/kg | Neurosurgery instructions |
| Midazolam | <15 kg 1 mg/ml ≥15 kg 5 mg/ml | 0.05-0.2 mg/kg/h | Bolus: 0,05-0,1 mg/kg |
| Morphine | <15 kg 0,1 mg/ml ≥15 kg 1 mg/ml | 5-30 µg/kg/h | Bolus: 0,05-0,1 mg/kg (The same strength and doses apply for oxycodone and ketogan) |
| Nimodipine (Nimotop) | 200 μg/ml | 20-30 µg/kg/h | |
| Noradrenaline (Norepinephrine) | 20 or 40 µg/ml | 20-300-(500) nanog/kg/min | Administered in a CVC |
| Thiopentone (Pentothal, Pentocur) | 25 mg/ml | 1-5(-10) mg/kg/h | EEG monitoring |
| Propofol (Propolipid) | 10 or 20 mg/ml | 1-3-(4) mg/kg/h | Children >3 years. Bolus: 1-3 mg/kg |
| Fentanyl | 50 μg/ml | 0.5-1 µg/kg/hour | Higher doses may be needed. Max 6 µg/kg/hour. |
Calculate Correct Medicine Doses
Enter the child’s weight to get recommended anesthetic drug doses.
Go to the calculator here.
Max Doses of Local Anesthetics for Children
- Lidocaine: 5 mg/kg
- Lidocaine + adrenaline: 7 mg/kg
- Ropivacaine: 2-3 mg/kg
- Mepivacaine: 5 mg/kg
- Bupivacaine 2 mg/kg
- Levobupivacaine: 2 mg/kg
Applies to children > 3 months. Based on ideal weight.
Maximum doses of local anesthetics for children
Dosed in ml by weight
| Weight (kg) | Bupivacaine 2,5 mg/ml | Bupivacaine 2,5 mg/ml + adrenalin | Bupivacaine 5 mg/ml | Bupivacaine 5 mg/ml + adrenalin | Lidocaine 10 mg/ml | Lidocaine 10 mg/ml + adrenalin | Mepivacaine 5 mg/ml | Mepivacaine 5 mg/ml + adrenalin | Weight (kg) |
|---|---|---|---|---|---|---|---|---|---|
| 10 | 8,0 ml | 12,0 ml | - | - | 5 ml | 7,0 ml | 10 ml | 14,0 ml | 10 |
| 12 | 9,6 ml | 14,4 ml | - | - | 6 ml | 8,4 ml | 12 ml | 16,8 ml | 12 |
| 14 | - | - | 5,6 ml | 8,4 ml | 7 ml | 9,8 ml | 14 ml | 19,6 ml | 14 |
| 16 | - | - | 6,4 ml | 9,6 ml | 8 ml | 11,2 ml | 16 ml | 22,4 ml | 16 |
| 18 | - | - | 7,2 ml | 10,8 ml | 9 ml | 12,6 ml | 18 ml | 25,2 ml | 18 |
| 20 | - | - | 8,0 ml | 12,0 ml | 10 ml | 14,0 ml | 20 ml | 28,0 ml | 20 |
| 22 | - | - | 8,8 ml | 13,2 ml | 11 ml | 15,4 ml | 22 ml | 30,8 ml | 22 |
| 24 | - | - | 9,6 ml | 14,4 ml | 12 ml | 16,8 ml | 24 ml | 33,6 ml | 24 |
| 26 | - | - | 10,4 ml | 15,6 ml | 13 ml | 18,2 ml | 26 ml | 36,4 ml | 26 |
| 28 | - | - | 11,2 ml | 16,8 ml | 14 ml | 19,6 ml | 28 ml | 39,2 ml | 28 |
| 30 | - | - | 12,0 ml | 18,0 ml | 15 ml | 21,0 ml | 30 ml | 42,0 ml | 30 |
| 32 | - | - | 12,8 ml | 19,2 ml | 16 ml | 22,4 ml | 32 ml | 44,8 ml | 32 |
| 34 | - | - | 13,6 ml | 20,4 ml | 17 ml | 23,8 ml | 34 ml | 47,6 ml | 34 |
| 36 | - | - | 14,4 ml | 21,6 ml | 18 ml | 25,2 ml | 36 ml | 50,4 ml | 36 |
| 38 | - | - | 15,2 ml | 22,8 ml | 19 ml | 26,6 ml | 38 ml | 53,2 ml | 38 |
| 40 | - | - | 16,0 ml | 24,0 ml | 20 ml | 28,0 ml | 40 ml | 56,0 ml | 40 |
Common Parenteral Antibiotics for Children
| Medication | Concentration | Dose | Note |
|---|---|---|---|
| Erythromycin | 10-15 mg/kg x 3 | Caution in liver failure and in heart disease (arrhythmias). Dose reduction in renal impairment. | |
| Phenoxymethylpenicilline (Bensyl PCV) | 100 mg/ml | 25-50 mg/kg x 3 (3g x 3) alt. 50-100 mg/kg x 4 (3 g x 4) | |
| Cefotaxime | 100 mg/ml | 30 mg/kg x 3. (1g x 3) alt. 75-100 mg/kg x 3 (3 g x 3) | |
| Ceftazidime | 100 mg/ml | 25 mg/kg x 3 (1 g x 3) alt. 50 mg/kg x 3 (2 g x 3) alt. 35 mg/kg x 3 (2 g x 3) Children< 2 months: 25 mg/kg x 2 | Diluted with sterile water. Given for 3-5 min. |
| Cefuroxime | 100 mg/ml | 20-30 mg/kg x 3 (0,75-1,5 g x 3) | Diluted with sterile water. Given for 3-5 min. |
| Clindamycin | 10 mg / kg x 3 (600 mg x 3) No child <4 weeks age | ||
| Cloxacillin | 50 mg/ml | Diluted with sterile water. Given in CVC 3-5 min. All infusion in pvc: Then dilute once more with NaCl 9mg/ml to 20 mg/ml. 20-30 min. | |
| Meropenem | 50 mg/ml | 40 mg/kg x 3 (2 g x 3) alt. 20 mg/kg x 3-4 (2 g x 3-4) alt. 10-20 mg/kg x 3 (0,5-1 g x 3) | Diluted with sterile water. Given for 3-5 min. |
| Tobramycin | 10 mg/ml | 7.5 mg/kg x 1. Higher dose 8-10-(12) mg/kg x1 can be used in CF and neutropenic fever. | Nebcina 40 mg/ml is diluted with NaCl 9 mg/ml alt. Glucose 50 mg/ml. Infusion for 20-60 min. |
| Vancomycin | 5 mg/ml | 20 mg/kg x 2 (-3) (1 g x 2) ev x 3 | Diluted in two steps. First stock solution with sterile water to 50 mg/ml. Then dilute with sodium chloride 9 mg/ml or glucose 50 mg/ml to 5 mg/ml. Infusion for at least 60 minutes. |
| Piperacillin/Tazobactam | 80 mg/kg x 3-4 alt. 100 mg/kg x 3-4 (4 g x 3-4) | ||
| Ceftriaxone | 100 mg/kg x 1. (2 g x 1) | ||
| Linezolid | 10 mg/kg x 2 (600 mg x 2) | (max 28 days) |
Morphine and Other Strong Analgesics for Children
Peripheral Analgesics
- Ketorolac (Toradol®) 0.3 mg/kg x 4 iv (not < 3-6 months, COX 1+2)
- Parecoxib (Dynastat®) 0.5 mg/kg x 1 iv (not < 3-6 months COX 2)
- Ibuprofen 7.5 mg/kg x 3-4 po (not < 3 months COX 1+2)
- Paracetamol po 15 mg/kg x 4 (first 3 days 20-25 mg/kg x 4)
- Paracetamol iv 15 mg/kg x 4 (use iv primarily the first postoperative day)
Morphine for postoperative pain in Pediatric Use
| Age | Loading dose morphine (mg/kg) | Cont. infusion morphine (μg/kg/h) |
|---|---|---|
| 0 - 3 months | 0.05 | 5-15 |
| 3 - 12 months | 0.1 | 10-20 |
| 1 - 5 years | 0.15 | 10 - 40 |
| 6 -12 years | 0.2 | 10 - 40 |
| 12 - 16 years | 0.25 | 10 - 40 |
Dosage of Morphine for Children
| Morphine | 1 mg/ml i v |
|---|---|
| Age | Dosage |
| <3 months | 50 µg/kg (0,05 mg/kg = 0,05 ml/kg of morphine 1 mg/ml) |
| 3-12 months | 100 µg/kg (0,1 mg/kg = 0,1 ml/kg of morphine 1 mg/ml) |
| 1-5 years | 150 µg/kg (0,15 mg/kg = 0,15 ml/kg of morphine 1 mg/ml) |
| 5-12 years | 200 µg/kg (0,20 mg/kg = 0,20 ml of morphine 1 mg/ml) |
| 12-15 years | 250 µg/kg (0,25 mg/kg = 0,25 ml/kg of morphine 1 mg/ml) |
Oxicodon for children (postoperative pain treatment)
| Oxicodon (Oxynorm) | 1 mg/ml |
|---|---|
| Oral solution | 0.1-0.2 mg/kg (max. 10 mg) up to 4 times/day |
| Given for severe opioid-sensitive pain. | ATTENTION! At least one hour of monitoring after the last dose! |
Fentanyl for children
| Fentanyl | 50 µg/ml (0.05 mg/ml) |
|---|---|
| Intravenously | 1 µg/kg |
| In continuous infusion for sedation in the ICU | 0,5-1 μg/kg/hour |
| Nasally | > 3 years 1,5 µg/kg |
Intravenous naloxone for children (Nexodal®)
| Naloxone iv | Dosage 2 µg/kg | The dose can be repeated if necessary |
|---|---|---|
| Weight (kg) | Solution 20 µg/ml | Solution 0.4 mg/ml (children > 20 kg) |
| 3-5 kg | 0,3-0,5 ml | |
| 5-10 kg | 0,5-1,0 ml | |
| 10-20 kg | 1,0-2,0 ml | |
| 20-40 kg | 2,0-4,0 ml | 0,1-0,2 ml |
| 40-80 kg | 4,0-8,0 ml | 0,2-0,4 ml |
ePed – Drug Information for Patients Under 18 Years
ePed is a national experience and evidence-based database for pediatric medicines. It currently contains about 1000 cross-regional drug instructions approved for use in units at various hospitals treating children and adolescents. ePed provides support in prescription, preparation, and administration of medicines to children. To access the instructions, you need to be logged in through your healthcare provider.
To find instructions for a specific medicine click here.
Antiemetics for Children
PONV Risk
- > 3 years of age
- Long anesthesia time
- Eye/ENT surgery
- Motion sickness
- Previous PONV
Prophylaxis
- Propofol induction
- Evacuate air from the stomach
- Keep the patient well-oxygenated
Treatment
- Ondansetron iv 0.1 mg/kg (max 4 mg)
- Betamethasone (Betapred) iv 0.2 mg/kg (max 4 mg)
- Droperidol (Dridol – not for children < 2 years) iv 0.02 mg/kg (max 1.25 mg)
Ondansetron to Children Dose mg/kg
| Weight (kg) | Intravenous Dose Solution 2 mg/ml | Weight (kg) | Oral dose Solution 0,8 mg/ml | Oral dose Tablet |
|---|---|---|---|---|
| ≥1 months: 0,1 mg/kg | Max 4 mg x 4 | ≥1 months: 0,2 mg/kg | Max 8 mg x 4 | |
| 8 - 14 kg | 1 mg = 0,5 ml | < 15 kg | 2 mg = 2,5 ml | 2 mg |
| 15 - 24 kg | 2 mg = 1 ml | 15 - 30 kg | 4 mg = 5 ml | 4 mg |
| 25 - 34 kg | 3 mg = 1,5 ml | > 30 kg | 8 mg = 10 ml | 8 mg |
| > 35 kg | 4 mg = 2 ml |
Other Antiemetics for Children
| Drug | Route | Remarks |
|---|---|---|
| Betametasone 4 mg/ml | Intravenous injection | |
| Dosage | 2 mg/kg | Max dose 4 mg x 1 |
| Metoclopramide 5 mg/ml | Intravenous injection | Children ≥ 1 year |
| Dosage | 0,15 mg/kg/dose | Max dose 10 mg x 3 |
| Phenergan 25 mg/ml | Children ≥ 1 year | |
| Intravenously | 0,5 mg/kg | |
| Orally | Tablet or Solution | Children ≥ 1 year. Max dose 25 mg x 4 |
| Droperidol 2,5 mg/ml | Intravenously 0,010 - 0,075 mg/kg | Max dose 1,25 mg x 4-6 |
Dexmedetomidine
Provides good premedication for small children coming in for ear, nose, and throat procedures. Dexmedetomidine injection solution (Dexdor®) 100 µg/ml can be administered both nasally and buccally. Nasal administration is preferred as it gives better absorption and quicker effect. The solution has no taste and does not sting in the nose. Dexmedetomidine is a specific alpha2 receptor agonist and its effect is similar to clonidine but with a more pronounced effect. The main effects are sedation and some analgesia. Dexmedetomidine has a shorter half-life, about 2 hours compared to clonidine’s 5-10 hours. The onset time is significantly longer compared to orally administered Midazolam, about 20-40 minutes.
Concentrate for infusion solution 100 µg/mL is used for NASAL use.
Nasally: Approximately 30 minutes before the procedure. Sedation usually occurs within 10-15 minutes, with maximum effect after 30 minutes. For deep sedation, the child should urinate before administration. If necessary, remove superficial secretions from both nostrils before administration. To adjust the dosage according to the patient’s weight, a Mucosal Atomization Device (MAD) is used. MAD is a single-use tip with a spray function that attaches to a 1 mL syringe.
HALF of the total dose should be administered in each nostril. The volume per nostril should be 0.1 – 0.2 mL (for children under 15 kg, a volume of 0.1 mL is suitable). This is to avoid the medicine running down the throat and not providing the desired effect. If the dosing volume is larger, the dose needs to be divided into multiple sprays. 0.1 – 0.2 mL is given in each nostril with at least 30 seconds up to 2 minutes between each spray. MAD must be pre-filled with dexmedetomidine (about 0.1 mL) before the first spray, this is to ensure the correct dose is administered. The syringe should not be filled with air behind the liquid, as the patient would receive too high a dose due to both the pre-fill and the volume in the syringe tip being sprayed out. Tilt the child’s head back and aim the syringe and adapter outward toward the nasal wings to optimize absorption. Push the plunger quickly and firmly so that the liquid is released as an aerosol. The same MAD can be used for any remaining sprays to the same patient. In these cases, pre-filling is not necessary. Remember to pre-fill each MAD before the first spray or if changing MAD between sprays.
COMMON INDICATION AND DOSE
Several cases of bradycardia (even) in the late stage have been reported.
Monitoring
Oxygen saturation, pulse, and blood pressure should be checked before administration and after the procedure is completed. During the procedure, the child should be under observation. For moderate to deep sedation: Continuous monitoring of oxygen saturation and pulse. For total doses from 3 µg/kg: Continuous monitoring of oxygen saturation and pulse as well as continuous monitoring with ECG. Additional monitoring/actions may be required, especially in combination with other drugs. Follow local guidelines.
Max dose Usually no more than 100 µg/DOSE (divided into multiple sprays). The effect of the given dose depends on the spray technique. A suitable max dose is determined by a reasonable volume for nasal administration and the child’s age.
Reasonable dose for dexmedetomidine nasal 100 microg/ml
| 1 kg | 5 kg | 10 kg | 50 kg | |
|---|---|---|---|---|
| 1 mikrog/kg | - | - | 0,1 mL | 0,5 mL |
| 2 mikrog/kg | - | 0,1 mL | 0,2 mL | 1 mL |
| 3 mikrog/kg | - | 0,15 mL | 0,3 mL | 1,5 mL |
Light sedation before procedure, e.g., insertion of PVK
Children 1 month – 18 years: Usual dose 1 – 2 µg/kg.
The dose can be repeated after 30 minutes if needed.
Moderate sedation before procedure, e.g., during LP
Children 1 month – 18 years: Usual dose 1 – 3 µg/kg.
The dose can be repeated after 30 minutes if needed.
Deep sedation before procedure, e.g., during MRI
Prescribed by a doctor with anesthesia or intensive care competence, or equivalent.
Children 1 – 5 months: Loading dose 2 µg/kg.
If needed, an additional 1 µ
g/kg can be given. Max 3 µg/kg.
Children 6 months – 18 years: Loading dose 3 – (4) µg/kg.
If needed, an additional 1 – (2) µg/kg can be given. Max 5 µg/kg.
Deep sedation before procedure, e.g., during MRI – for NEWBORNS
Very limited experience with use in newborns. Should only be prescribed in exceptional cases. Continuous monitoring with ECG, oxygen saturation, and pulse is required. Newborns (premature): Individual dosing, usually requires significantly lower doses than those listed below.
Newborns (full-term with birth weight over 3 kg): Loading dose 2 µg/kg. If
needed, an additional 1 (- 2) µg/kg can be given.
Premedication with Intranasal Sufentanil for Children
Indication
Children undergoing anesthesia where sedation is considered appropriate before induction.
Contraindication
Ongoing nosebleed or other nasal obstruction.
Administration of intranasal sufentanil requires the presence of anesthesia personnel, continuous monitoring capability, and possibly ventilation support.
Effect
Sedation is usually achieved within 10 – 15 minutes, and maximum analgesic effect occurs after 20 – 25 minutes. In some patients, the effect may occur within a few minutes.
Dosage/Administration
- Sufentanil 1 microgram/kg (50 micrograms/ml) is administered with a 2 ml syringe connected to a Mucosal Aerosol Device (MAD). Use a Luer Lock syringe to prevent the MAD from detaching during injection.
- Total dose 1 – 2 micrograms/kg: Half the dose is administered in each nostril.
- Administer one syringe with 0.1 – 0.2 ml at a time. During application, aim upwards inside the nostril towards the eyes (in the cranial direction).
- Apply in both nostrils as quickly as possible. It is important to use force on the plunger to achieve aerosolization.
- Uncertain effect with larger volume, as part of the dose passes by the nasal mucosa and is swallowed.
Dosage Dexmedetomidine
Sufentanil administered nasally for children
| Weight (kilo) | Dose (microgram) | Volume (ml) |
|---|---|---|
| 10 | 20 | 0.4 |
| 13 | 26 | 0.5 |
| 15 | 30 | 0.6 |
| 18 | 36 | 0.7 |
| 20 | 40 | 0.8 |
| 23 | 46 | 0.9 |
| 25 | 50 | 1 |
| 28 | 56 | 1.1 |
| 30 | 60 | 1.2 |
| 35 | 70 | 1.4 |
| 40 | 80 | 1.6 |
| 45 | 90 | 1.8 |
| 50 | 100 | 2 |
| 55 | 110 | 2.2 |
| 60 | 120 | 2.4 |
References
- Bayrak F, Gunday I, Memis D, Turan A. A comparison of oral midazolam, oral tramadol, and intranasal sufentanil premedication in pediatric patients. J Opioid Manag. 2007 Mar-Apr;3(2):74-8.
- Zedie N, Amory DW, Wagner BK, O’Hara DA. Comparison of intranasal midazolam
Inhalation of Racemic Adrenaline (Racepinephrine)
Racepinephrine (22,5 mg/ml)
Dilute with sodium chloride to a volume of 2 ml for nebulization. Not given directly in the tube without nebulization.
| Body Weight | Racepinephrine (22,5 mg/ml) (Micronefrin) Volume for inhalation (ml) |
|---|---|
| < 5 kg | 0,25 ml |
| 5-10 kg | 0,3 ml |
| 10-15 kg | 0,5 ml |
| 15-20 kg | 0,7 ml |
Inhalation
Decongestant + Bronchodilation:
- Mix with physiological saline (NaCl) to at least 2 ml
- Adrenaline 1 mg/ml
- < 2 years: 1 mg
- ≥ 2 years: 2 mg
- Racepinephrine (0.4 mg/kg) 22.5 mg/ml. (No advantage compared to adrenaline – dose is twice that of adrenaline)
Bronchodilation
- Salbutamol (Ventoline) 5 or 1 mg/ml 0.15 mg/kg x 4-6 max 5 mg/dose
- Ipratropium (Atrovent) 0.25 mg/ml < 12 years: 0.25 mg ≥12 years: 0.5 mg
Steroid Schedule for Children
Betamethasone (Betapred) schedule for children is recommended for children < 30 kg. For children weighing 30-60 kg, a half adult schedule is recommended. Children over 60 kg are considered adults and the adult schedule is recommended.
| Injection Betametasone 1 mg/ml | Dose (ml) | Dose (mg) |
|---|---|---|
| Day 1 | 2 ml x 2 | 2 mg x 2 |
| Day 2 | 2 ml x 2 | 2 mg x 2 |
| Day 3 | 1 ml x 2 | 1 mg x 2 |
| Day 4 | 1 ml x 2 | 1 mg x 2 |
| Day 5 | 0,5 ml x 1 | 0,5 mg x 1 |
| Day 6 | 0,5 ml x 1 | 0,5 mg x 1 |
| Orally | Tablet 0,5 mg | Dose (mg) |
| Day 1 | 4 st x 2 | 2 mg x 2 |
| Day 2 | 4 st x 2 | 2 mg x 2 |
| Day 3 | 2 st x 2 | 1 mg x 2 |
| Day 4 | 2 st x 2 | 1 mg x 2 |
| Day 5 | 1 st x 1 | 0,5 mg x 1 |
| Day 6 | 1 st x 1 | 0,5 mg x 1 |
Disclaimer:
The content on AnesthGuide.com is intended for use by medical professionals and is based on practices and guidelines within the Swedish healthcare context.
While all articles are reviewed by experienced professionals, the information provided may not be error-free or universally applicable.
Users are advised to always apply their professional judgment and consult relevant local guidelines.
By using this site, you agree to our Terms of Use.