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Anaesthetic drug crib sheet 8

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Fa Munir

This document provides guidance on common anaesthetic drugs and their typical doses for an average adult patient. It lists induction agents like propofol and thiopental, opioids such as fentanyl and alfentanil, muscle relaxants including atracurium, vecuronium and rocurium, and reversal agents neostigmine and glycopyrronium. It also details local anaesthetics bupivacaine and lidocaine as well as emergency drugs for issues like laryngospasm, bradycardia, hypotension, suspected anaphylaxis, local anaesthetic toxicity, and malignant hyperthermia. Users are advised to discuss these doses with trainers and adjust according to local practice.

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Basic Anaesthetic Drugs Doses are for an average adult. They are provided as a guide to the usual range of doses for fit ASA1/2 adult patients only. You should discuss these doses with your trainers and adjust the document as required according to local practice. *= Titrate to effect. Induction Agents Dose Presentation Propofol 2–3 mg/kg 10 mg/ml Thiopental 3–5 mg/kg 25 mg/ml – Beware of antibiotics in 20 ml syringe Opioids Dose Presentation Fentanyl* 1 mcg/kg 50 mcg/ml Alfentanil* 10 mcg/kg 500 mcg/ml Morphine* 0.1 mg/kg 10 mg/ml Muscle Relaxants Dose (Intubation) Top ups Presentation Atracurium 0.5 mg/kg Approximately half intubating dose 10 mg/ml (stored in fridge) Vecuronium 0.1 mg/kg 2 mg/ml Rocuronium 0.6 mg/kg 10 mg/ml (stored in fridge) Suxamethonium 1–1.5 mg/kg 50 mg/ml (stored in fridge) Reversal for muscle relaxants Neostigmine 2.5 mg + Glycopyrronium 500 mcg Local Anaesthetics Toxic Dose Formulation/Max Dose Bupivacaine 2 mg/kg 0.25% = 2.5 mg/ml (Max dose 0.8 ml/kg) 0.5% = 5 mg/ml (Max dose 0.4 ml/kg) Lidocaine 3 mg/kg without adrenaline 6 mg/kg with adrenaline 1% = 10 mg/ml 2% = 20 mg/ml Common Emergency Drugs Use Dose Presentation Suxamethonium Laryngospasm 25–50 mg 50 mg/ml (fridge) Atropine* Bradycardia 20 mcg/kg 1 mg/ml Glycopyrronium* Bradycardia 200 mcg bolus 200 mcg/ml Ephedrine* Hypotension 3 mg bolus 30 mg diluted into 10 ml saline Metaraminol* Hypotension 0.5 mg bolus 10 mg diluted into 20 ml saline Adrenaline* Suspected anaphylaxis 50–100 mcg boluses titrated to effect 0.5–1 ml of 1:10,000 Other Emergency Drugs Intralipid 20% Local anaesthetic toxicity – initial dose 1.5 ml/kg IV over 1 min Dantrolene Malignant Hyperthermia – initial dose 2.5 mg/kg IV (9 vials for 70 kg Px)

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Anaesthetic drug crib sheet 8

  • 1. Basic Anaesthetic Drugs Doses are for an average adult. They are provided as a guide to the usual range of doses for fit ASA1/2 adult patients only. You should discuss these doses with your trainers and adjust the document as required according to local practice. *= Titrate to effect. Induction Agents Dose Presentation Propofol 2–3 mg/kg 10 mg/ml Thiopental 3–5 mg/kg 25 mg/ml – Beware of antibiotics in 20 ml syringe Opioids Dose Presentation Fentanyl* 1 mcg/kg 50 mcg/ml Alfentanil* 10 mcg/kg 500 mcg/ml Morphine* 0.1 mg/kg 10 mg/ml Muscle Relaxants Dose (Intubation) Top ups Presentation Atracurium 0.5 mg/kg Approximately half intubating dose 10 mg/ml (stored in fridge) Vecuronium 0.1 mg/kg 2 mg/ml Rocuronium 0.6 mg/kg 10 mg/ml (stored in fridge) Suxamethonium 1–1.5 mg/kg 50 mg/ml (stored in fridge) Reversal for muscle relaxants Neostigmine 2.5 mg + Glycopyrronium 500 mcg Local Anaesthetics Toxic Dose Formulation/Max Dose Bupivacaine 2 mg/kg 0.25% = 2.5 mg/ml (Max dose 0.8 ml/kg) 0.5% = 5 mg/ml (Max dose 0.4 ml/kg) Lidocaine 3 mg/kg without adrenaline 6 mg/kg with adrenaline 1% = 10 mg/ml 2% = 20 mg/ml Common Emergency Drugs Use Dose Presentation Suxamethonium Laryngospasm 25–50 mg 50 mg/ml (fridge) Atropine* Bradycardia 20 mcg/kg 1 mg/ml Glycopyrronium* Bradycardia 200 mcg bolus 200 mcg/ml Ephedrine* Hypotension 3 mg bolus 30 mg diluted into 10 ml saline Metaraminol* Hypotension 0.5 mg bolus 10 mg diluted into 20 ml saline Adrenaline* Suspected anaphylaxis 50–100 mcg boluses titrated to effect 0.5–1 ml of 1:10,000 Other Emergency Drugs Intralipid 20% Local anaesthetic toxicity – initial dose 1.5 ml/kg IV over 1 min Dantrolene Malignant Hyperthermia – initial dose 2.5 mg/kg IV (9 vials for 70 kg Px)