Indication
ICU light sedation, awake fibre-optic intubation, weaning sedation.
Preparation
200 mcg in 50 mL NS (4 mcg/mL).
Dilution
200 mcg / 50 mL → 4 mcg/mL
Rate
Loading 1 mcg/kg over 10 min (often omitted); maintenance 0.2–1.4 mcg/kg/h.
Monitoring
- • BP, HR (bradycardia)
- • Sedation depth (RASS)
Common errors
- • Loading dose in elderly / hypovolaemic → severe bradycardia/hypotension
- • Abrupt cessation after >24 h → withdrawal
Pearls
- • Allows co-operative sedation
- • Reduces delirium vs benzodiazepines (MENDS, SEDCOM)
