Indications And Dose
Analgesia and enhancement of anaesthesia at induction (initial bolus injection) ▶BY INTRAVENOUS INJECTION ▶Adult: Initially 0.25–1 microgram/kg, dose to be administered over at least 30 seconds, if patient is to be intubated more than 8 minutes after start of intravenous infusion, initial bolus intravenous injection dose is not necessary Analgesia and enhancement of anaesthesia at induction with or without initial bolus dose ▶BY INTRAVENOUS INFUSION ▶Adult: 30–60 micrograms/kg/hour, if patient is to be intubated more than 8 minutes after start of intravenous infusion, initial bolus intravenous injection dose is not necessary Assisted ventilation: analgesia and enhancement of anaesthesia during maintenance of anaesthesia (initial bolus injection) ▶BY INTRAVENOUS INJECTION ▶Adult: Initially 0.25–1 microgram/kg, dose to be administered over at least 30 seconds Assisted ventilation: analgesia and enhancement of anaesthesia during maintenance of anaesthesia with or without initial bolus dose ▶BY INTRAVENOUS INFUSION ▶Adult: 3–120 micrograms/kg/hour, dose to be administered according to anaesthetic technique and adjusted according to response, in light anaesthesia additional doses can be given by intravenous injection every 2–5 minutes during the intravenous infusion Spontaneous respiration: analgesia and enhancement of anaesthesia during maintenance of anaesthesia ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 2.4 micrograms/kg/hour, adjusted according to response; usual dose 1.5–6 micrograms/kg/hour Assisted ventilation: analgesia and sedation in intensive- care patients (for max 3 days) ▶BY INTRAVENOUS INFUSION ▶Adult: Initially 6–9 micrograms/kg/hour, then adjusted in steps of 1.5 micrograms/kg/hour, allow at least 5 minutes between dose adjustments; usual dose 0.36–44.4 micrograms/kg/hour, if an infusion rate of 12 micrograms/kg/hour does not produce adequate sedation add another sedative (consult product literature for details) Assisted ventilation: additional analgesia during stimulating or painful procedures in intensive-care patients ▶BY INTRAVENOUS INFUSION ▶Adult: Usual dose 15–45 micrograms/kg/hour, maintain infusion rate of at least 6 micrograms/kg/hour for at least 5 minutes before procedure and adjust every 2–5 minutes according to requirements Cardiac surgery ▶Adult: (consult product literature) DOSES AT EXTREMES OF BODY-WEIGHT ▶To avoid excessive dosage in obese patients, dose should be calculated on the basis of ideal body-weight. l UNLICENSED USE Remifentanil doses in BNF may differ from those in product literature.
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