Produces sedation/hypnosis rapidly (within 40 sec) and smoothly with minimal excitation; decreases IOP and systemic vascular resistance; rarely is associated with malignant hyperthermia and histamine release; suppresses cardiac output and respiratory drive.
Induction and maintenance of anesthesia in adults; induction anesthesia in children at least 3 yr of age; maintenance anesthesia in children at least 2 mo of age; initiation and maintenance of monitored anesthesia care sedation in adults; sedation in intubated or respiratory-controlled adult ICU patients.
Induction of anesthesia, by intravenous injection or infusion, 1.5–2.5 mg/kg (less in those over 55 years) at a rate of 20–40 mg every 10 seconds; CHILD over 1 month, administer slowly until response (usual dose in child over 8 years 2.5 mg/kg, may need more in younger child,
Maintenance of anesthesia, by intravenous injection, 25–50 mg repeated according to response or by intravenous infusion, 4–12 mg/kg/hour; CHILD over 3 years, by intravenous injection or infusion, 9–15 mg/kg/hour
Sedation in intensive care, by intravenous infusion, adult over 17 years, 0.3–4 mg/kg/hour
Situations in which general anesthesia or sedation are contraindicated.
ý difficulty breathing, wheezing, swelling of the throat
ý fast heartbeat, palpitations
ý lightheadedness or fainting spells
ý numbness or tingling in the hands or feet
ý seizure (convulsion)
ý skin rash, flushing (redness), or itching
ý swelling or extreme pain at the injection site
ý uncontrollable muscle spasm
ý Should be administered only by personnel who are trained in administration of general anesthesia and familiar with drug.
ý Administer only in settings in which resuscitation equipment is immediately available.
ý Shake well before use. Do not use if there is evidence of separation of phases of emulsion.
ý Maintain strict aseptic technique in handling; rapid growth of organisms may occur if contaminated.
ý Dilute with dextrose 5% injection, but do not dilute to concentration less than 2 mg/mL. Drug is compatible with dextrose 5%; lactated Ringer's injection; lactated Ringer's and dextrose 5% injection; dextrose 5% and sodium chloride 0.45% injection; dextrose 5% and sodium chloride 0.2% Injection.
ý Minimize pain associated with administration by infusing into larger veins.
ý Discard any unused portions of drug or solution at end of anesthetic procedure; do not keep for more than 6 h.
In ICU sedation discard after 12 h if administered directly from vial or after 6 h if transferred to syringe or other container.