Uses and Dosage of Barbiturates

Agent HS Total Volume Use Route Dose (mg/kg) Onset

Thiopental induction iv 3-6 30-60 sec
sedation iv 0.5-1.5 30-60 sec

Uses and Dosage of Benzodiazepines

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Diazepam 5 mg Premedication oral 0.2-0.5 15-45 min
5 mg/ml Sedation iv 0.04-0.2 1-5 min
Induction iv 0.3-0.6 1-5 min
Midazolam 5 mg/ml 1 ml Premedication im 0.07-0.15 15 min
Sedation iv 0.01-0.1 2-3 min
Induction iv 0.1-0.4 2-3 min
Lorazepam 2 mg Premedication Oral 0.05 45 min

Uses and Dosage of Opioids

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Morphine 1 mg/ml Premedication im 0.05-0.2
Intra op analgesia iv 0.1-1 15-30 min
Post op analgesia iv 0.03-0.15 15-30 min
Pethidine 10 mg/ml Premedication im 0.5-1 rapid
Intra op analgesia iv 2.5-5 rapid
Post op analgesia iv 0.2-0.5 rapid
Fentanyl 50 mcg/ml 2 ml Pre Induction iv 1-3 mcg/kg 6 min
Intra op analgesia iv 2-150 mcg/kg 6 min
Post op analgesia iv 0.5-1.5 mcg/kg 6 min

Uses and Dosage of Ketamine, Etomidate and Propofol

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Ketamine 50 mg/ml Induction iv 1-2 30 sec
Induction im 3-5
Analgesia iv 0.05-0.1 30 sec
Etomidate 2 mg/ml Induction iv 0.2-0.5 30-60 sec
Propofol 10 mg/ml 20 ml Induction iv 1-2.5 30-45 sec
Maintenance iv 50-200 mcg/kg 30-45 sec
Sedation iv 25-100 mcg/kg 30-45 sec

Uses and Dosage of Muscle Relaxants

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Succinylcholine 20 mg/ml Intubation iv 1-1.5 30-60 sec
Maintenance iv 0.15 30-60 sec
Infusion iv 2-15 30-60 sec
Rocuronium 10 mg/ml 5 ml Intubation iv 0.6-1.2 1-2 min
Maintenance iv 0.15 1-2 min
 Infusion iv 3-12 mcg/min 1-2 min
Atracurium 10 mg/ml Intubation iv 0.4-0.5 2-2.5 min
Maintenance iv 0.1 2-2.5 min
Infusion iv 4-12 mcg/min 2-2.5 min

Uses and Dosage of Local Anesthetic

Agent HS Total Volume Use Route Toxic (mg/kg) Onset
Bupivacaine 5 mg/ml All iv 3 15-30 min
Lidocaine 20 mg/ml All iv 4.5 45-90 sec

Uses and Dosage of Anticholinergic

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Atropine 0.5 mg/ml iv 0.01-0.02 < 1 hr

Uses and Dosage of Cholinesterase Inhibitors

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Neostigmin 1 mg/ml Reverse Relaxants iv 0.04-0.08 5-10 min

Uses and Dosage of Adrenergic Agonist

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Clonidine 0.5 mg/ml Antihipertensive iv 1-3 mcg/kg < 1 hr
Intrathecal 75-150 mcg < 1 hr
Epidural 30 mcg/hr < 1 hr
Ephedrine 50 mg/ml Hypotension iv 0.1 rapid

Uses and Dosage of Gastro Intestinal Related Drugs

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Ranitidin 25 mg/ml Increase Gastric pH iv 1 - 2.5 1-2 hr
Omeprazole 20 mg Increase Gastric pH po 0.35 1 hr
Metoclopramide 10 mg/ml Anti Emetic iv 0.25 - 1.8 1-3 min

Uses and Dosage of Adjunct Anesthesia

Agent HS Total Volume Use Route Dose (mg/kg) Onset
Ketorolac 30 mg/ml Analgesia iv 0.25-1 1-3 min
Post op analgesia po 30-60 min
Tramadol 50 mg/ml Analgesia iv 1-3 45-60 min
Paracetamol 10 mg/ml Analgesia iv 10-15 15-30 min
Post op analgesia po 10-15
Ondansetron 4 mg/ml Anti Emetic iv 0.15 5 min
Naloxone 1 mg/ml Opioid Reverse iv 1-4 mcg/kg 1-2 min
Continous iv 5 mcg/kg/hr 1-2 min
Dexamethasone 5 mg/ml Anti emetic iv
Diphenhydramine
fgmikee@gmail.com
 Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval
20-30 min 5.5 - 26 hr 30 sec
20-30 min

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

7-8 hr 20 - 100 hr 15 - 60 min Liver Kidney
15-60 min
15-60 min
1 hr 1.8 - 6.4 hr 30 min Liver Kidney + GI
20-40 min
20-40 min
12-24 hr 9 - 16 hr 1.5 - 2 hr Liver Kidney

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

7 hr 2 - 3 hr 20 min Liver Kidney + GI
7 hr
7 hr
2-4 hr 3 - 5 hr 30 min Liver Kidney
2-4 hr 1 min
2-4 hr 1 min
30-60 min 2 - 4 hr 30 - 60 min Liver Kidney + GI
30-60 min
30-60 min

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

5-10 min 2.5 - 3 hr 1 min Liver Kidney + GI
5- 10 min 10-15 min
5-10 min
3-5 min 75 min Liver + Plasma Kidney
20-75 min 30 - 60 min 4 - 8 min Liver Kidney
20-75 min
20-75 min

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

2-10 min 1-2 min Plasma Kidney
2-10 min
2-10 min
30-60 min 1 - 2 min 4 min Liver Kidney
30-60 min 14 - 18 min
30-60 min
20-35 min 17 - 21 min 3-5 min Plasma Kidney + GI
20-35 min
20-35 min

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

1.5-8 hr 3.5 hr 30-45 min Liver Kidney
10-20 min 1.5 - 2 hr 10-15 hr Liver Kidney

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

4 hr 2 hr 30 min Liver Kidney

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

2.5 - 4 hr 50 - 90 min 20-30 min Plasma + Liver Kidney

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

6-10 hr 12 - 33 hr 3-5 hr Liver Kidney
6-10 hr
6-10 hr
60 min 3 - 6 hr 2-4 hr Liver Kidney

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

4 - 5 hr 2 - 3 hr Liver Kidney
12-24 hr 0.5 - 1 hr 0.5 - 3.5 hr Liver Kidney
1-2 hr 5 - 6 hr Liver Kidney

Duration Half-Time Peak Plasma Metabolism Excretion Dosing Interval

6-8 hr 3.5 - 9.2 hr 1-3 min Liver Kidney + GI q6
6-8 hr 3.5 - 9.2 hr 1 hr Liver Kidney + GI q6
9 hr 5.5 - 7 hr 1.5 hr Liver Kidney q8
2-5 hr 1 - 4 hr 0.25 hr Liver Kidney q6
6 hr Liver Kidney q6
12 hr 5.7 hr Liver Kidney
30-45 min 1 - 1.5 hr Kidney
POST OP ORDER MNEMONICS
V Monitor vital signs (HR, BP, RR, spO2) q15 for 2 hours then q30 until stable
O Give Oxygen 6 LPM via face mask
S Suction if nescessary
T Give warm blankets or may add warmer if necessary
P Position supine with 30 degree head elevation
E Educate patient to take a deep breath once in a while
D Diet as tolerated
I IVFD lactated ringers 110 ml/hr (70 kg) to follow PNSS 110 ml/kg
A Medication : Ketorolac 30 mg po q8 / Paracetamol 1g po q6 / Tramadol 100 mg po q6
R Referal
 EXTUBATION CRITERIA
No SUBJECTIVE
1 Clear oropharynx/hypopharynx
2 Intact gag reflex
3 Minimal end expiratory volatile anesthetics
4 Adequate pain control
5 Follows command
6 Sustained head lift for 5 sec
7 Sustained hand grasp
OBJECTIVE
Tidal Volume > 6 ml/kg
Peak voluntary negative inspiratory pressure > 20 cm H2O
Vital capacity > 10 ml/kg
Dead space to tidal volume ratio < 0.6
Sustained tetanic contraction (5sec)
T1/T4 ratio > 0.7
Alveolar-arterial PaO2 gradient (FiO2 1.0) < 350 mmHg