Indication
Rapid rate control (perioperative HTN, aortic dissection, refractory SVT).
Preparation
2.5 g (10 mL of 250 mg/mL) in 250 mL D5W.
Dilution
10 mg/mL
Rate
Load 500 mcg/kg over 1 min → 50 mcg/kg/min. Re-bolus and ↑by 50 mcg/kg/min q4 min (max 200 mcg/kg/min).
Monitoring
- • Continuous BP + HR
- • Infusion site (phlebitis)
Common errors
- • Peripheral irritation at high concentration
- • Overdose → prolonged hypotension (short t½ so recovery quick)
Pearls
- • t½ 9 min — safe titration in unstable patients
- • Central preferred but peripheral acceptable short-term
