# Peds Anesthesia Drug Reference

## Resuscitation

### Atropine
0.01-0.03 mg/kg IM, IV, ET, IC, IO

### Bicarbonate

1-2 mEq/kg (0.3 x kg x BE) IV, IC, IO

### Calcium Chloride
> 10% (27 mg Ca++/ml)

0.1 - 0.3 ml/kg IV, IC slowly (max 1 g/dose)

### Calcium Gluconate
> 10% (9 mg Ca++/ml)

0.6-1 ml/kg (max 2 g/dose) IV, IC

### Dextrose
0.5-1 g/kg IV = 1-2 ml/kg D50
2-4 ml/kg D25W
5-10 ml/kg D10W
10-20 ml/kg D5NS

### Diltiazem (Cardizem)
0.25 mg/kg over 2 min;
May repeat in 15 min @ 0.35 mg/kg over 2 min

### Ephedrine
0.2-0.3 mg/kg/dose

### Epinephrine (1:10,000)
10 mcg/kg = 0.1 ml/kg IV, IC, IO;
[ET = 0.1 mg/kg (0.1 ml/kg of 1:1,000)]

### Lidocaine
1 mg/kg IV, IC, ET, IO

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## Sedatives

### Chloral Hydrate
30-80 mg/kg/dose PO, PR

### Clonidine
0.004 mg/kg PO (Max 0.1 mg)

### Diphenhydramine
0.2-2 mg/kg/dose IV q4-6h;
or 1.25 mg/kg/dose q6h (Max 400 mg/d)

### Etomidate
0.3 mg/kg IV

### Haloperidol
0.4-5 mg/dose

### Ketamine
IV Induction 2-3 mg/kg;
IM induction 5-8mg/kg;
Maintenance: 0.1-0.5 mg/kg/**hr**
3 mg/kg intranasal

### Methohexital
1-2 mg/kg/dose IV;
30-40 mg/kg PR

### Midazolam
0.05-0.3 mg/kg IV, IM;
Infusion: 0.4 mcg/kg/min
PO: 0.5-0.75 mg/kg
PR: 0.5-1 mg/kg
Intranasal: 0.2 mg/kg

### Pentobarbital
2 mg/kg IM, IV, PO

### Propofol
2-3 mg/kg IV;
Maintenance: 50-300 mcg/kg/min

### Thiopental
3-7 mg/kg IV
PR: 20-40 mg/kg

---
## Opioids
> dosed by lean body weight

### Fentanyl
0.5-1 mcg/kg/dose IV q1h prn

### Hydrocodone/Oxycodone
0.05-0.15 mg/kg PO
q4h (usual start dose 0.1 mg/kg)

### Hydromorphone
5-10 mcg/kg/dose IV q2-4h prn
50-80 mcg/kg/dose PO q4h

### Meperidine
1 mg/kg/dose IV q2h prn
For rigors 0.1 mg/kg/dose IV once

### Methadone
50-100mcg/kg/dose PO/IM/IV/SQ (max 20mg)
0.2 mg/kg for spine cases

### Morphine
0.05-0.15 mg/kg/dose IV q2-4h prn
0.2-0.3 mg/kg/dose PO q4h

### Remifentanil
0.1-0.5 mcg/kg/min infusion

### Sufentanil
> ~10x more potent than fentanyl

10-25 mcg/kg induction

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## Neuromuscular Blockers
Cisatracurium: 0.1-0.2 mg/kg/dose IV; lasts 15 - 45 min

Metubine: 0.1-0.4 mg/kg/dose IV; lasts 1-2 h

Mivacurium: 0.2-0.3 mg/kg/dose IV; lasts 15-20 min

Pancuronium: 0.1 mg/kg/dose IV; lasts 1-2 h

Rocuronium: 0.4-1.0 mg/kg/dose IV; lasts 20-45 min

Succinylcholine: 1-2 mg/kg IV; 4 mg/kg IM;
> consider giving atropine first

Vecuronium: 0.1 mg/kg/dose IV; lasts 30 min

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## Antibiotics

Ampicillin: 50 mg/kg max 2gm

Amp/Sulbactam (Unasyn): 75 mg/kg/dose slowly IV over 10-15min

Cefazolin: 30 mg/kg/dose IV q6h

Clindamicin: 10 mg/kg/dose (Max 900mg) q6h

Gentamicin: 2-2.5 mg/kg/dose (Max 120 mg)

Metronidazole (Flagyl): 15 mg/kg/load;
Maintenance: 7.5 mg/kg/dose IV, PO q6h

Pip/Tazo (Zosyn):
80-100 mg/kg (max 3.375gms) q2h
2-9 mos: 80 mg/kg q2h

Vancomycin: 15 mg/kg q8h slowly IV

## Misc

### ETT Sizing

Endotracheal tube size = 4 + Age/4
Endotracheal depth > 1 yr = 12 + Age/2 or 10 + Age

Blade Size:
Newborn = #0 Miller
1-18 mos = #1 Miller
1.5 – 8 yrs = #2 Mac/Miller
8+ yrs = #3 Mac/Miller

### One-lung Ventilation

| Age (yrs) | ETT (ID in mm) | BB (Fr) | Univent® | DLT (Fr) |
|:---------:|:--------------:|:-------:|:--------:|:--------:|
| 0.5-1 | 3.5-4.0 | 5 | | |
| 1-2 | 4.0-4.5 | 5 | | |
| 2-4 | 4.5-5.0 | 5 | | |
| 4-6 | 5.0-5.5 | 5 | | |
| 6-8 | 5.5-6 | 5 | 3.5 | |
| 8-10 | 6.0 cuffed | 5 | 3.5 | 26 |
| 10-12 | 6.5 cuffed | 5 | 4.5 | 26-28 |
| 12-14 | 6.5-7.0 cuffed | 5 | 4.5 | 32 |
| 14-16 | 7.0 cuffed | 5 | 6.0 | 35 |
| 16-18 | 7.0-8.0 cuffed | 5 or 9 | 7.0 | 35 |