Indication
ICU analgosedation, severe acute pain.
Preparation
500 mcg in 50 mL NS (10 mcg/mL).
Dilution
500 mcg / 50 mL → 10 mcg/mL
Rate
25–200 mcg/h; bolus 25–50 mcg PRN.
Monitoring
- • RR (if not ventilated)
- • Sedation, pain score
- • Bowels
Common errors
- • Accumulation in obesity / hepatic failure
- • Chest wall rigidity with large rapid bolus
Pearls
- • Rapid onset (~1 min), shorter than morphine
- • Pair with bowel regimen
