Anesthesia Calculator for Drug Dosages, Fluids, and ETT Sizes

×

BMI is a measure of body fat based on weight and height, commonly used to identify if a patient is underweight, normal weight, overweight, or obese. This information is critical for anesthesiologists in planning safe medication dosages and airway management strategies.

A higher BMI may indicate increased anesthesia risks, while a lower BMI can highlight sensitivities to certain medications. Calculating BMI helps personalize care to a patient’s specific physical profile.

The formula for calculating BMI is: $\mathrm{BMI}=\frac{\mathrm{Weight (kg)}}{{\mathrm{Height (m)}}^2}$

×

IBW estimates a healthy body weight based on a patient's height, age, and gender. It is essential for determining appropriate drug dosages and assessing nutritional status in anesthesia management.

The formulas for calculating IBW are as follows:

Adult: $\mathrm{IBW}=\mathrm{Base Weight}+0.9\times \mathrm{Height (cm)}-152$ kg
Base Weight is 50 kg for males and 45.5 kg for females.

×

AjBW estimates a patient's optimal body weight, particularly in overweight or obese individuals. It assists anesthesiologists in determining accurate medication dosages by accounting for excess body fat.

The formula for calculating AjBW is: $\mathrm{AjBW}=\mathrm{IBW}+0.4\times \mathrm{Weight}-\mathrm{IBW}$

×

LBW is the estimated body weight excluding body fat. It helps in determining drug dosages for anesthesia, as fat-free body mass is more metabolically active. This formula is generally used for adult patients.

The formulas for calculating LBW are as follows:

Male: $\mathrm{LBW}=1.1\times \mathrm{Weight (kg)}-128\times \frac{{\mathrm{Weight (kg)}}^2}{{\mathrm{Height (cm)}}^2}$ kg

Female: $\mathrm{LBW}=1.07\times \mathrm{Weight (kg)}-148\times \frac{{\mathrm{Weight (kg)}}^2}{{\mathrm{Height (cm)}}^2}$ kg

×

Habitus refers to the general body structure or build of an individual. It is often classified using Body Mass Index (BMI) categories, which help in assessing the patient's body composition and potential risks associated with different weight ranges.

Habitus Categories by BMI:

• Underweight: BMI < 18.5
• Normal weight: BMI 18.5–24.9
• Overweight: BMI 25–29.9
• Obesity: BMI ≥ 30

×

Body Surface Area (BSA) is an estimated measure of the total skin area of a person. It is widely used in medical calculations for determining drug dosages, fluid requirements, and other physiological assessments.

The formula for calculating BSA using the Mosteller formula is:

$\mathrm{BSA}=\sqrt{\frac{\mathrm{Weight (kg)}\times \mathrm{Height (cm)}}{3600}}$ m²

×

V_t is the amount of air moved in and out of the lungs with each breath. It is typically calculated based on body weight to optimize ventilation, reduce lung injury risk, and improve gas exchange. Standard V_t settings range between 6–8 mL/kg of body weight.

The formula for calculating V_t is:

$\mathrm{TV}=\mathrm{Body Weight (kg)}\times \mathrm{TV per kg (mL)}$ mL

Range: 6–8 mL/kg

×

HR represents the number of heartbeats per minute. Monitoring HR helps assess a patient's cardiovascular status, detect abnormalities, and guide anesthesia management.

Normal HR Ranges by Age:

• Infants (0–1 year): 100–160 bpm
• Children (1–10 years): 70–120 bpm
• Adolescents (10–18 years): 60–100 bpm
• Adults (18+ years): 60–100 bpm

×

RR refers to the number of breaths a person takes per minute. Monitoring RR helps assess a patient's respiratory status and can indicate various physiological conditions.

Normal RR Ranges by Age:

• Infants (0–1 year): 30–60 bpm
• Children (1–10 years): 18–30 bpm
• Adolescents (10–18 years): 12–20 bpm
• Adults (18+ years): 12–20 bpm

×

Mean Arterial Pressure (MAP) indicates the average blood pressure in the arteries throughout the cardiac cycle. It is essential for ensuring adequate organ perfusion. Below are the reference ranges for MAP based on age.

Normal MAP Ranges by Age:

• Infants (0–1 year): 45–60 mmHg
• Children (1–10 years): 55–70 mmHg
• Adolescents (10–18 years): 70–90 mmHg
• Adults (18+ years): 70–105 mmHg

×

MV represents the total volume of air a patient breathes in one minute. Estimated MV is provided as a range based on body weight and an age-specific factor to help guide ventilation needs.

Estimated Minute Ventilation Ranges by Age:

• Infants (0–1 year): 180–200 mL/kg/min
• Children (1–10 years): 140–160 mL/kg/min
• Adolescents (10–18 years): 90–110 mL/kg/min
• Adults (18+ years): 60–80 mL/kg/min

×

Blood Volume is the estimated total volume of blood within a patient’s circulatory system. This estimation, based on body weight and age, provides a reference for understanding how much blood loss a patient can tolerate safely.

Estimated Blood Volume Ranges by Age:

• Infants (0–1 year): 80–90 mL/kg
• Children (1–10 years): 70–80 mL/kg
• Adolescents (10–18 years): 65–75 mL/kg
• Adults (18+ years): 65–70 mL/kg

×

Maintenance fluids are used to provide adequate hydration for a patient based on their weight. The calculation follows the 4-2-1 Rule, which adjusts fluid needs based on the first, next, and remaining kilograms of weight.

Maintenance Fluids Calculation (4-2-1 Rule):

• First 10 kg: 4 mL/kg/hr
• Next 10 kg: 2 mL/kg/hr
• Each kg above 20 kg: 1 mL/kg/hr

×

VD refers to the volume of air that remains in the airways and does not participate in gas exchange. It is estimated based on body weight, providing a reference for assessing ventilation efficiency.

The estimated anatomical dead space is calculated as: $\mathrm{VD}=\mathrm{Weight (kg)}\times 2.2$ mL

×

The recommended endotracheal tube (ETT) size is based on age, weight, and gender, helping to ensure a proper fit for ventilation and reduce the risk of airway trauma. Different recommendations apply to neonates, pediatric patients, and adults.

ETT Size Guidelines:

• Neonates and Infants (Weight-Based):
  • ≤1 kg: 2.5 mm
  • 1–2 kg: 3.0 mm
  • 2–3 kg: 3.5 mm
  • >3 kg: 3.5–4.0 mm
• Children (1 Year and Older):
  • Uncuffed Tube: (Age/4) + 4 mm
  • Cuffed Tube: (Age/4) + 3.5 mm
• Adults (Gender-Based):
  • Male: 8.0–9.0 mm ID
  • Female: 7.0–8.0 mm ID

×

The recommended fixation length for the endotracheal tube (ETT) helps ensure the tube is neither too shallow nor too deep, minimizing the risks of dislodgement or endobronchial intubation. Fixation length is based on age, weight, and gender.

ETT Fixation Length Guidelines:

• Pediatrics:
  • Neonates (≤3 kg): 7–8 cm
  • Infants (3–12 kg): 8–10 cm
  • Children (12–25 kg): 10–12 cm
  • Age-Based Formula: (Age/2) + 12 cm
• Adults:
  • Male: 21–23 cm
  • Female: 19–21 cm

×

The recommended size for the laryngeal mask airway (LMA) is based on the patient's weight. Correct sizing ensures an effective seal and reduces the risk of airway trauma. The table below also provides suggested cuff inflation volumes for each LMA size.

LMA Size and Cuff Volume Guidelines:

• Up to 5 kg: Size 1 (4 mL cuff volume)
• 5–10 kg: Size 1.5 (7 mL cuff volume)
• 10–20 kg: Size 2 (10 mL cuff volume)
• 20–30 kg: Size 2.5 (14 mL cuff volume)
• 30–50 kg: Size 3 (20 mL cuff volume)
• 50–70 kg: Size 4 (30 mL cuff volume)
• 70–100 kg: Size 5 (40 mL cuff volume)
• >100 kg: Size 6 (50 mL cuff volume)

×

The recommended Macintosh laryngoscope blade size is based on age and weight, ensuring an appropriate fit for visualizing the airway structures during intubation. Different sizes are available for neonates, children, and adults.

Macintosh Blade Size Guidelines:

• Preterm Neonates (<2 kg): Size 0
• Neonates (0–28 days, 2–3 kg): Size 0
• Infants (1–12 months, 3–10 kg): Size 1
• Toddlers (1–3 years, 10–15 kg): Size 1.5
• Children (3–10 years, 15–30 kg): Size 2
• Older Children (10–12 years, 30–50 kg): Size 2–3
• Adolescents and Adults (>50 kg): Size 3–4

×

The recommended Miller laryngoscope blade size is based on age and weight, ensuring an appropriate fit for visualizing the airway structures in neonates, children, and adults when direct laryngoscopy is performed.

Miller Blade Size Guidelines:

• Preterm Neonates (<2 kg): Size 00
• Neonates (0–28 days, 2–3 kg): Size 0
• Infants (1–12 months, 3–10 kg): Size 1
• Children (1–3 years, 10–15 kg): Size 1
• Children (3–6 years, 15–20 kg): Size 1.5
• Older Children (6–10 years, 20–30 kg): Size 2
• Adolescents and Adults (>30 kg): Size 2–3

×

The recommended nasopharyngeal airway (NPA) size is based on the patient’s age and weight. The NPA should be comfortable and effective, ensuring a patent airway while minimizing airway trauma.

NPA Size Guidelines:

• Neonates (<3 kg): 2.0–2.5 mm ID
• Infants (3–10 kg): 2.5–3.0 mm ID
• Toddlers (10–15 kg): 3.0–4.0 mm ID
• Children (15–30 kg): 4.0–5.0 mm ID
• Older Children (30–50 kg): 5.0–6.0 mm ID
• Adolescents and Adults (>50 kg): 6.0–8.0 mm ID

×

Propofol is an intravenous induction agent used for rapid anesthesia induction and total intravenous anesthesia (TIVA). It is characterized by rapid recovery, minimal nausea, and is commonly chosen for TIVA.

Dosage Guidelines:

• Pediatric Dosage:
  • Induction: 2–4 mg/kg
  • Infusion: 4–15 mg/kg/hr
  • Not recommended (NR) for induction in patients <1 month old
  • Not recommended (NR) for maintenance in patients <3 years old
• Adult Dosage:
  • Induction: 2–3 mg/kg
  • Infusion: 6–10 mg/kg/hr
  • Total Intravenous Anesthesia (TCI):
    • Initially 4–8 µg/mL
    • Then 3–6 µg/mL (reduce in elderly)

Description and Perioperative Indications: IV induction agent. Rapid recovery and minimal nausea. First-line drug in TIVA.

Cautions and Contraindications: Reduce dose in elderly or if hemodynamically unstable. Exercise caution in patients with severe allergies to peanuts, soya, or soybean oil.

Side Effects: Apnoea, hypotension, pain on injection, myoclonic spasms, and, rarely, convulsions.

×

Thiopental is a short-acting thiobarbiturate used for induction of anesthesia, anticonvulsant effects, and cerebral protection. Recovery is due to redistribution.

Dosage Guidelines:

• Pediatric Dosage:
  • Induction: Neonate 2–4 mg/kg, Child 5–6 mg/kg
  • Status epilepticus: 2–4 mg/kg, then 8 mg/kg/h infusion
• Adult Dosage:
  • Induction/cerebral protection: 3–5 mg/kg
  • Anticonvulsant: 0.5–2 mg/kg PRN

Description and Perioperative Indications: Short-acting thiobarbiturate used for anesthesia induction, anticonvulsant effects, and cerebral protection.

Cautions and Contraindications: Risk of accumulation with repeated doses. Caution in hypovolemia, elderly patients, and porphyria.

Side Effects: Hypotension and necrosis if administered intra-arterially.

×

Ketamine is a phencyclidine derivative that produces dissociative anesthesia. It is used for induction and maintenance of anesthesia, particularly in high-risk and hypovolemic patients.

Dosage Guidelines:

• Pediatric Dosage:
  • Induction: IV 0.5–2 mg/kg, IM 5–10 mg/kg
  • Infusion: 10–45 µg/kg/min
  • Caudal: 0.5 mg/kg (preservative-free only)
• Adult Dosage:
  • Induction: IV 1–2 mg/kg, IM 5–10 mg/kg
  • Infusion: 1–3 mg/kg/h (analgesia only 0.25 mg/kg/h)

Description and Perioperative Indications: Phencyclidine derivative producing dissociative anesthesia. Used for induction/maintenance in high-risk and hypovolemic patients.

Cautions and Contraindications: Risk of emergence delirium (reduced by benzodiazepines), use caution in hypertension. Control excess salivation with an antimuscarinic agent.

Side Effects: Bronchodilation, increase in BP, salivation, and uterine tone. Rapid administration may cause respiratory depression. Weak evidence for transient ICP increase; more likely to lower ICP. Small increase in CBF; safe in traumatic brain injury (TBI) based on recent evidence.

×

Etomidate is a short-acting intravenous anesthetic agent used primarily for induction of anesthesia, especially in hemodynamically unstable patients, due to its minimal cardiovascular effects.

Dosage Guidelines:

• Pediatric Dosage: Induction: 0.2–0.3 mg/kg IV
• Adult Dosage: Induction: 0.2–0.3 mg/kg IV

Description and Perioperative Indications: Short-acting IV anesthetic used for induction, particularly in patients with unstable hemodynamics, as it has minimal cardiovascular effects.

Cautions and Contraindications: May cause adrenal suppression with prolonged use; consider alternatives for continuous infusion.

Side Effects: Adrenal suppression, myoclonus, nausea, and vomiting.

×

Suxamethonium is a depolarizing muscle relaxant used for rapid, short-acting muscle paralysis. Phase II block may develop with repeated doses (>8 mg/kg). It should be stored at 2–8°C.

Dosage Guidelines:

• Pediatric Dosage:
  • IV: 1–2 mg/kg
  • IM: 3–4 mg/kg
• Adult Dosage:
  • IV: 1–1.5 mg/kg
  • Infusion: 0.5–10 mg/min

Description and Perioperative Indications: Depolarizing muscle relaxant providing rapid, short-acting muscle paralysis. Phase II block may occur with repeated dosing.

Cautions and Contraindications: Use caution in patients with plasma cholinesterase deficiency, hypokalemia, hypocalcemia, malignant hyperthermia (MH), and neuromuscular disorders. Serum potassium levels may increase, especially in burns, trauma, and upper motor neuron injury.

Side Effects: Increased intraocular pressure (IOP) and bradycardia with repeated dosing.

×

Rocuronium is a rapidly acting aminosteroid non-depolarizing muscle relaxant (NDMR) used for rapid sequence intubation (RSI) as an alternative to suxamethonium. It provides intubating conditions within 1 minute, with a variable duration of action lasting 10–40 minutes.

Dosage Guidelines:

• Pediatric Dosage:
  • Intubation: 0.6–1 mg/kg
  • Maintenance: 0.1–0.15 mg/kg
  • Infusion: 0.3–0.6 mg/kg/hr
• Adult Dosage:
  • Intubation: 0.6–1 mg/kg
  • Maintenance: 0.1–0.15 mg/kg
  • Infusion: 0.3–0.6 mg/kg/hr

Description and Perioperative Indications: Rapidly acting aminosteroid NDMR. Used in rapid sequence intubation (RSI) as an alternative to suxamethonium. Duration varies between 10–40 minutes.

×

Atracurium is a benzylisoquinolinium non-depolarizing muscle relaxant (NDMR) that undergoes Hofmann elimination and non-specific enzymatic ester hydrolysis, making it useful in patients with severe renal or hepatic disease. The duration of action is typically 20–35 minutes.

Dosage Guidelines:

• Pediatric Dosage:
  • Intubation: 0.3–0.6 mg/kg
  • Maintenance: 0.1–0.2 mg/kg
  • Infusion: 0.3–0.6 mg/kg/hr (monitor blockade)
• Adult Dosage (using Ideal Body Weight - IBW):
  • Intubation: 0.3–0.6 mg/kg
  • Maintenance: 0.1–0.2 mg/kg
  • Infusion: 0.3–0.6 mg/kg/hr (monitor NMB)

Description and Perioperative Indications: Benzylisoquinolinium NDMR that undergoes Hofmann elimination and non-specific enzymatic hydrolysis, making it suitable for patients with severe renal or hepatic disease.

Cautions and Contraindications: Potentiated by aminoglycosides, loop diuretics, magnesium, lithium, decreased temperature, decreased potassium, decreased pH, prior use of suxamethonium, and volatile agents. Store at 2–8°C.

Side Effects: Mild histamine release and rash are common with higher doses. Flush with 0.9% sodium chloride before and after administration.

×

Cisatracurium is a single isomer of atracurium with greater potency, longer duration of action (approximately 55 minutes), and less histamine release compared to atracurium.

Dosage Guidelines:

• Pediatric Dosage:
  • Intubation (≥1 month): 150 µg/kg
  • Maintenance (≥2 years): 30 µg/kg every 20 minutes
  • Infusion (≥2 years): 0.06–0.18 mg/kg/h
• Adult Dosage:
  • Intubation: 150 µg/kg
  • Maintenance: 30 µg/kg every 20–30 minutes
  • Infusion: 0.06–0.18 mg/kg/h

Description and Perioperative Indications: Single isomer of atracurium with longer duration of action and less histamine release, lasting approximately 55 minutes.

Cautions and Contraindications: Enhanced effect in myasthenia gravis; effects are antagonized by anticholinesterases. Monitor response with peripheral nerve stimulation (PNS).

×

Fentanyl is a synthetic phenylpiperidine derivative opioid analgesic with high lipid solubility and cardiostability. Commonly used in perioperative settings due to its potent analgesic effect and rapid onset.

Dosage Guidelines:

• Pediatric Dosage:
  • Induction: 1–5 µg/kg (up to 50 µg/kg if ventilating postoperatively)
  • Infusion: 2–4 µg/kg/hr
• Adult Dosage:
  • Induction: 1–5 µg/kg (up to 50 µg/kg)
  • Epidural: 50–100 µg (diluted in 10 mL of 0.9% sodium chloride or local anesthetic)
  • Spinal: 5–20 µg

Description and Perioperative Indications: Synthetic phenylpiperidine derivative opioid analgesic with high lipid solubility and cardiostability. Duration 30–60 minutes.

Cautions and Contraindications: Reduce dose in elderly patients. Risk of delayed respiratory depression and pruritus if administered epidurally or via spinal route.

Side Effects: Circulatory and ventilatory depression. High doses may produce muscle rigidity.

×

Morphine is an opioid analgesic commonly used for pain relief with a half-life of 2–4 hours.

Dosage Guidelines:

• Pediatric Dosage:
  • PO: 0.05–0.3 mg/kg every 4 hours
  • IV boluses: 50–100 µg/kg
• Adult Dosage:
  • IV: 2.5–10 mg
  • IM/SC: 5–10 mg every 4 hours
  • PO: 10–30 mg every 4 hours
  • PCA: 1 mg with 5-minute lockout
  • Infusion: 1–3.5 mg/h
  • Epidural: 2–5 mg preservative-free
  • Spinal: 0.1–1 mg preservative-free

Description and Perioperative Indications: Opioid analgesic with a half-life of 2–4 hours.

Cautions and Contraindications: Prolonged risk of respiratory depression, pruritus, and nausea when used via spinal or epidural routes.

Side Effects: Histamine release, hypotension, bronchospasm, nausea, vomiting, pruritus, and dysphoria.

×

Meperidine, also known as pethidine, is an opioid analgesic commonly used for moderate to severe pain management. It has a shorter duration of action compared to morphine and can be used for postoperative shivering.

Dosage Guidelines:

• Pediatric Dosage:
  • Analgesia: 1–1.5 mg/kg IM/SC/IV every 3–4 hours
  • Shivering: 0.5 mg/kg IV
• Adult Dosage:
  • Analgesia: 50–150 mg IM/SC/IV every 3–4 hours as needed
  • Shivering: 25–50 mg IV

Description and Perioperative Indications: Opioid analgesic used for moderate to severe pain and postoperative shivering. Has a shorter duration of action compared to morphine.

Cautions and Contraindications: Avoid use in patients with renal impairment due to accumulation of neurotoxic metabolite (normeperidine). Use caution in elderly patients and those with seizure disorders.

Side Effects: Respiratory depression, sedation, dizziness, nausea, vomiting, hypotension, and risk of seizures with prolonged use or high doses.

×

Acetaminophen, also known as paracetamol, is a non-opioid analgesic and antipyretic used for mild to moderate pain and fever reduction. It is available in oral, intravenous, and rectal formulations.

Dosage Guidelines:

• Pediatric Dosage:
  • Oral/Rectal: 10–15 mg/kg every 4–6 hours, not to exceed 75 mg/kg/day
  • IV (≥2 years): 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours (max 75 mg/kg/day)
• Adult Dosage:
  • Oral/Rectal: 500–1000 mg every 4–6 hours, not to exceed 4000 mg/day
  • IV: 1000 mg every 6 hours or 650 mg every 4 hours (max 4000 mg/day)

Description and Perioperative Indications: Non-opioid analgesic and antipyretic used for pain relief and fever reduction, available in multiple formulations.

Cautions and Contraindications: Use caution in patients with liver impairment or chronic alcohol use. Avoid exceeding the recommended daily dose to prevent hepatotoxicity.

Side Effects: Rare but may include liver toxicity with overdose, nausea, rash, and hypersensitivity reactions.

×

Atropine is a muscarinic acetylcholine antagonist that blocks vagal activity at the AV and sinus nodes, leading to an increase in heart rate. As a tertiary amine, it can cross the blood–brain barrier.

Dosage Guidelines:

• Pediatric Dosage:
  • IV: 10–20 µg/kg
  • Control of muscarinic effects of neostigmine: 20 µg/kg
  • IM/SC: 10–30 µg/kg
  • PO: 40 µg/kg
• Adult Dosage:
  • IV: 300–600 µg
  • Prevention of muscarinic effects of neostigmine: 600–1200 µg

Description and Perioperative Indications: Muscarinic acetylcholine antagonist. Blocks vagal activity, increasing heart rate. Can cross the blood–brain barrier.

Cautions and Contraindications: Use caution in obstructive uropathy, cardiovascular disease, glaucoma, and myasthenia gravis.

Side Effects: Decreases secretions, reduces lower esophageal sphincter tone, relaxes bronchial smooth muscle, and may cause confusion in the elderly.

×

Dexamethasone is a prednisolone derivative corticosteroid with less sodium retention than hydrocortisone. It is used for cerebral edema, edema prevention, and as an antiemetic.

Dosage Guidelines:

• Pediatric Dosage:
  • IV/IM/SC: 83–333 µg/kg in 1–2 divided doses (max 20 mg/day)
  • Cerebral Edema: See BNF for Children
  • Croup: 150 µg/kg ± repeat at 12 hours
  • Antiemetic: 150 µg/kg (max 8 mg)
• Adult Dosage:
  • IV/IM/SC: 3.3–6.6 mg
  • Cerebral Edema: 8–16 mg initially, then 5 mg qds (use 3.8 mg/mL preparation)
  • Antiemetic: 3.3–6.6 mg

Description and Perioperative Indications: Prednisolone derivative corticosteroid with reduced sodium retention. Effective for cerebral edema, edema prevention, and as an antiemetic.

Cautions and Contraindications: Interacts with anticholinesterase agents, increasing weakness in myasthenia gravis. Different formulations available (e.g., dexamethasone sodium phosphate), dosing refers to dexamethasone base.

×

Ondansetron is a serotonin (5-HT3) receptor antagonist used as an antiemetic to prevent nausea and vomiting.

Dosage Guidelines:

• Pediatric Dosage (≥1 year):
  • Slow IV: 100 µg/kg (max 4 mg) qds
• Adult Dosage:
  • Slow IV/IM/PO: 4–8 mg tds

Description and Perioperative Indications: Serotonin (5-HT3) receptor antagonist antiemetic.

Cautions and Contraindications: Risk of QT interval prolongation.

Side Effects: Hypotension, headache, flushing.

×

Glycopyrrolate is a quaternary ammonium anticholinergic agent used for bradycardia, blocking muscarinic effects of anticholinesterases, and as an antisialogogue.

Dosage Guidelines:

• Pediatric Dosage: 4–10 µg/kg
• Adult Dosage:
  • 200–400 µg
  • Control of muscarinic effects of neostigmine: 200 µg per 1 mg of neostigmine

Description and Perioperative Indications: Quaternary ammonium anticholinergic agent used for bradycardia and muscarinic blockade during anticholinesterase administration.

Cautions and Contraindications: Use with caution in glaucoma and cardiovascular disease. Unlike atropine, glycopyrrolate does not cross the blood–brain barrier.

Side Effects: Paradoxical bradycardia at low doses and reduction in lower esophageal sphincter tone.

×

Neostigmine is an anticholinesterase used for the reversal of non-depolarizing muscle relaxants (NDMR) and treatment of myasthenia gravis. It has an IV duration of approximately 60 minutes and a PO duration of 2–4 hours.

Dosage Guidelines:

• Pediatric Dosage: 50 µg/kg with atropine 20 µg/kg or glycopyrronium 10 µg/kg
• Adult Dosage:
  • IV: 50–70 µg/kg (max 5 mg) with atropine 10–20 µg/kg or glycopyrronium 10–15 µg/kg
  • PO: 15–30 mg at suitable intervals

Description and Perioperative Indications: Anticholinesterase used for reversal of non-depolarizing muscle relaxants (NDMR) and treatment of myasthenia gravis.

Cautions and Contraindications: Administer with an antimuscarinic agent to counteract muscarinic effects.

Side Effects: Bradycardia, nausea, and excessive salivation (muscarinic effects).

×

Naloxone is a pure opioid antagonist used to reverse opioid effects. It can be administered in low doses to counteract pruritus from epidural opioids and as a depot IM injection in newborns exposed to maternal opioids.

Dosage Guidelines:

• Pediatric Dosage:
  • Reversal: 5–10 µg/kg
  • Infusion: 5–20 µg/kg/h
  • IM Depot in Newborns: 200 µg
  • Pruritus: 0.5 µg/kg
• Adult Dosage:
  • Reversal: 200–400 µg, titrated to effect
  • Pruritus: Infusion rate 0.25–1 µg/kg/h ± bolus of 40–100 µg

Description and Perioperative Indications: Pure opioid antagonist for reversing opioid effects, pruritus management, and neonatal IM depot.

Cautions and Contraindications: Be aware of renarcotisation if reversing long-acting opioids. Caution in opioid-dependent patients as it may precipitate acute withdrawal. Duration of action is approximately 30 minutes.

Side Effects: Arrhythmias, dizziness, headache, hypertension, hypotension, nausea, and vomiting.