Anesthesiology
James Lamberg
Medications
Pre-Medications Midazolam (50-350mcg/kg) mg; O:30-60s, P:3-5m, D:15-80m Zofran 4mg; O:<30m, P:variable, D:12-24h (if pt with risk factors for PONV) Fentanyl (0.7-2mcg/kg) mcg; O:30s, P:5-15m, D:30-60m Dexamethasone (5-10mg) mg (if pt with risk factors for PONV); O:3m, P:12-24h, D:36-54h Induction Lidocaine (1.5-2mg/kg) mg to attenuate pressor response to DL; O:45-90s, P:1-2m, D:10-20m Propofol (1.5-2.5mg/kg) mg; O:45s, P:1m, D:5-10m Thiopental (3-5mg/kg) mg; O:10-20s, P:30-40s, D:5-15m Etomidate (0.1-0.2mg/kg) mg; O:30-60s, P:1m, D:3-10m Ketamine (1-2.5mg/kg) mg; O:<30s, P:1m, D:5-15m Neuromuscular Blockers Succinylcholine (1-1.5mg/kg) mg; O:30-60s, P:60s, D:4-6m Rocuronium (0.6-1.2mg/kg) mg; O:45-60s, P:1-3m, D:15-150m Vecuronium (0.08-0.1mg/kg) mg; O:<3m, P:3-5m, D:25-30m Atracurium (0.3-0.5mg/kg) mg; O:<3m, P:3-5m, D:20-35m Cisatracurium (0.15-0.2mg/kg) mg; O:1.5-2m, P:3-7m, D:20-35m Pancuronium (0.04-0.1mg/kg) mg; O:1-3m, P:3-5m, D:40-65m Alfentanil (25-50mcg/kg) mcg (for relaxation of cords without NMB) Maintenance, Inhalation Agents Sevoflurane 2% (0.7% in N2O) Isoflurane 1.2% (0.6% in N2O) Desflurane 6% (2.8% in N2O) Maintenance, Narcotics Morphine (2.5-5mg) mg; O:<1m, P:5-20m, D:2-7h Fentanyl (0.7-2mcg/kg) mcg; O:30s, P:5-15m, D:30-60m Sufentanil (0.2-0.6mcg/kg) mcg; O:1-3m, P:3-5m, D:20-45m Alfentanil (5-10mcg/kg) mcg; O:1-2m, P:1-2m, D:10-15m Remifentanil (0.25-0.4mcg/kg/min) Infusion Only, No Bolus; O:<30m, P:3-5m, D:5-10m Toradol 30mg (0.5mg/kg) mg; O:<1m, P:1-3h, D:3-7h Emergence Neostigmine (0.05mg/kg) mg; O:<3m, P:3-14m, D:40-60m+ Glycopyrrolate (0.2mg per ml neostigmine) mg; O:<1m, P:5m, D:2-3h, N/A with LMA Dilaudid 0.5mg when spontaneously breathing. Titrate to RR of 12; O:immediate, P:5-20m, D:2-4h Morphine (2.5-15mg) mg; O:<1m, P:20m, D:2-7h MAC Midazolam (50-350mcg/kg) mg; O:30-60s, P:3-5m, D:15-80m Zofran 4mg; O:<30m, P:variable, D:12-24h (if pt with risk factors for PONV) Fentanyl (0.7-2mcg/kg) mcg; O:30s, P:5-15m, D:30-60m Remifentanil (0.5-1mcg/kg/min) Infusion Only, No Bolus; O:<30m, P:3-5m, D:5-10m Dexamethasone (5-10mg) mg (if pt with risk factors for PONV); O:3m, P:12-24h, D:36-54h Propofol (25-100mcg/kg/min) mg; O:40s, P:1m, D:5-10m Thiopental (0.05-0.35mg/kg/min) mg; O:10-20s, P:30-40s, D:5-15m Etomidate (5-20mcg/kg/min) mg; O:30-60s, P:1m, D:3-10m Ketamine (15-80mcg/kg/min) mg; O:<30s, P:1m, D:5-15m PRN Phenylephrine (50-100mcg) mcg; O:<1m, P:<1m, D:15-20m Ephedrine (5-10mg) mg; O:immediate, P:2-5m, D:10-60m Glycopyrrolate (0.2mg) mg; O:<1m, P:5m, D:2-3h Atropine (0.4-1mg) mg; O:45-60s, P: 2m, D:1-2h Esmolol (10-20mg) mg; O:1-2m, P:5m, D:10-20m Labetalol (2.5-20mg) mg; O:2-5m, P:5-15m, D:2-4h Metoprolol (5mg) mg; O:immediate, P:20m, D:5-8h Hydralazine (0.1-0.2mg/kg) mg; O:5-20m, P:10-80m, D:2-4h Propranolol (10-30mcg/kg) mcg; O:<2m, P:1m, D:1-6h Lidocaine (1-1.5mg/kg arrhythmia, 1.5-2mg/kg pressor response) mg; O:45-90s, P:1-2m, D:10-20m
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