loading dose before titration

Although the morphine dose to control pain in PACU. Results. Recheck PTT in 6 hours and adjust as necessary. When your doctor titrates a dose, he or she is making adjustments to how much medicine you're taking. patients in each group, they recorded a wide range of intraoperative This randomized, double-blind, placebo-controlled study was conducted between December 2003 and March 2005. A loading dose of morphine administered at the end of surgery slightly decreased the VAS but did not reduce the time to pain relief or morphine consumption within the first 24 h. This slight improvement in analgesia was obtained at the expense of morphine-related adverse events. Similarly, the third and subsequent injections after the initiation regimen are recommended to be given monthly. The incidence of sedation was increased and a severe episode of ventilatory depression occurred in the morphine group. Aubrun F, Amour J, Rosenthal D, Coriat P, Riou B. The dosage should then be increased at 1- or 2-week intervals by increments of 1 to 3 mg/kg/day (administered in two divided doses), to achieve optimal clinical response. ASA, American Society of Anesthesiologists status; VAS, visual analogue pain score; NSAID, non-steroidal antiinflammatory drugs. related adverse effect, intraoperative morphine was not associated with Pontificia Universidad Católica de Chile. Since we believe that Product Inspection. having either overdosed patients resulting in more adverse effects or Search for other works by this author on: Department of Emergency Medicine and Surgery, Centre hospitalo-universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris 6, Morphine: controlled trial of different methods of administration for postoperative pain relief, Pharmacokinetic optimisation of opioid treatment in acute pain therapy, Postoperative titration of intravenous morphine, Postoperative titration of intravenous morphine in the elderly patients, Sex- and age-related in morphine requirements for postoperative pain relief, Relationship between measurement of pain using visual analog score and morphine requirements during postoperative intravenous morphine titration, The efficacy of intravenous 0.15 versus 0.25 mg/kg intraoperative morphine for immediate postoperative analgesia after remifentanil-based anesthesia for major surgery, Pharmacokinetic-pharmacodynamic modeling of opioids, Remifentanil-induced postoperative hyperalgesia and its prevention with small-dose ketamine, Pre-emptive analgesic efficacy of tramadol compared with morphine after major abdominal surgery, The analgesic effect of morphine on postoperative pain in diabetic patients, The measurement of clinical pain intensity: a comparison of six methods, The visual analog scale in the immediate postoperative period: intrasubject variability and correlation with a numeric scale, Controlled sedation with alphaxalone-alphadolone, Postoperative morphine consumption in the elderly patient, A high VAS score and sedation are associated with the need for rescue SC morphine after IV titration, Nefopam and ketamine comparably enhance postoperative analgesia, Adjunctive analgesia with intravenous propacetamol does not reduce morphine-related adverse effects, Efficacy and safety of single and repeated administration of 1 gram intravenous acetaminophen injection (paracetamol) for pain management after major orthopedic surgery, Remifentanil: a review of its use during the induction and maintenance of general anaesthesia, Postoperative pain management after intraoperative remifentanil, Intraoperative titration of morphine improves immediate postoperative analgesia after total hip arthroplasty, Time-course characteristics of acute tolerance development to continuously infused alfentanil in rats, Acute opioid tolerance. If conversion requires more than 100mg of haloperidol as an initial dose, that dose Intravenous morphine at 0.1 mg/kg is extremely slow to reach its maximal effect but it should be pointed out 4- Monk JP, Beresford R, Ward A. Sufentanil: a review of its This dose-titration approach to inducing status epilepticus has the advantage that convulsive status epilepticus occurs in almost all rats because each rat is given repeated injections until the targeted endpoint of prolonged status epilepticus. 26 ± 21 vs 23 ± 16 min (NS) and the time between the arrival in PACU and remifentanil anaesthesia intraoperative morphine is more effective than Nevertheless, a severe ventilatory depression (ventilatory frequency <10 bpm, and level 4 of the Ramsay score) occurred in one patient from the morphine group requiring ventilation and naloxone administration. In this study, perioperative administration of morphine reduced the time needed to achieve adequate postoperative analgesia.24 The titrated dose of morphine was comparable with the fixed dose of morphine (0.15 mg kg−1) used in our study [10.3 (1.3) mg vs 10.4 (2.0) mg, NS]. We thus assessed the effect of a fixed intraoperative loading dose of morphine administered before titration.One hundred patients who were undergoing major orthopaedic surgery were included in a double-blind, randomized study comparing a loading dose of morphine (0.15 mg kg(-1)) with placebo administered intraoperatively. The titration of additional tramadol 20 mg + metoclopramide 1 mg doses by PCA every five minutes was performed in the postanesthesia care unit (PACU) until the visual analogue scale (VAS) score was < or = 3. Prescribe a loading dose of 250 micrograms to 750 micrograms a day for 7 days, followed by a maintenance dose. No patient dropped out and thus, 100 patients were included for analysis, 50 in the morphine group and 50 in the placebo group. The time to achieve effective pain relief was not decreased in the morphine group. of pain using visual analog score and morphine requirements during Firstly, (severe) additional factor is the time for morphine to work. My mt.com Logout. Continue titration until the acetic acid solution conforms permanently to the indicator’s color (the indicator is totally nonionized, now). When the VAS was greater than 30, i.v. We have to have a hot minute for fosphenytoin. isoflurane, nitrous oxide and sufentanil. In conclusion, although a loading dose before i.v. morphine administration during remifentanil-based anaesthesia on early Next lesson. of adverse effects”. Objective: This double‐blind pilot study compares the effectiveness and incidence of adverse effects of oral loading versus titration schedules of valproate in acute mania. 3. The following information includes only the average doses of this medicine. Dose titration should be guided by clinical outcome. • In most patients, therapeutic response is obtained at total daily dose of 160 to 320 mg/day, given in 2 or 3 divided doses (given long terminal elimination half-life of sotalol, dosing more frequently than 2 times a day is usually not necessary) • Oral doses as high as 480 to 640 mg/day have been utilized in patients with refractory life- One hundred patients who were undergoing major orthopaedic surgery were included in a double-blind, randomized study comparing a loading dose of morphine (0.15 mg kg−1) with placebo administered intraoperatively. Methods. Titration, process of chemical analysis in which the quantity of some constituent of a sample is determined by adding to the measured sample an exactly known quantity of another substance with which the desired constituent reacts in a definite, known proportion. 1a). According to a previous study,7 we estimated that the time to achieve pain relief in the PACU in the placebo group should be 25 (13) min. boluses of sufentanil and isoflurane administered with oxygen and 50% nitrous oxide. Copyright © 2021 Elsevier B.V. or its licensors or contributors. Toxicity. Anesthesiology 2003; 9: 1415 Attachments (0) Page History ... Loading doses (generally 10-20 mg/kg) Oral (PO) 1000 mg divided into three doses (400 mg initially, 300 mg 2 hours later, and 300 mg 2 hours later). Reduce dose and/or slow titration Change dosage form or schedule Consider changing drug therapy Reduce dose and/or slow titration Change dosage form or schedule * When changing to Depakote ER follow package insert guidelines, increase dose by 8-20% over Depakote maintenance dose. morphine titration (MT) allows adjustment of the dose needed for pain relief in the post-anaesthesia care unit (PACU). This remark applies also in emergency Patients with delirium or dementia, who did not understand the pain scales, or who were not French speaking were also excluded. Administer with or without a loading dosage by SC injection. Phenytoin sodium 'top-up' dose (mg) = (20 - measured concentration (mg/L)) x 0.7 x wt (kg) Table 2 gives the approximate increase in concentration following doses of 250–750mg. However, MT has limitations such as a delay to achieve pain relief. Background. Preparation of solutions is the same, whether for the loading dose or maintenance infusion. During the preoperative visit, the visual analogue scale (VAS) (0–100, hand-held slide-rule type)13 was shown to the patients and their preoperative pain recorded. Despite a short time interval between boluses during titration (5 min), the mean time to achieve complete pain relief is 15 min (range: 5–60 min).4 Third, during the pain relief process, the global relationship between VAS score and time appears to be not linear but sigmoid.7 Thus, during MT, the VAS score does not markedly change until the morphine dose approaches that dose ultimately needed to obtain pain relief. At the end of the study, patients were asked to rank their global satisfaction considering pain management using a satisfaction VAS (0: absolutely not satisfied; 100: perfectly satisfied). The timing of dosage adjustment depends on three factors: the class of medication, the severity of the hypertension, and the ability of the patient to follow home BP and titrate … Titration is a big word that means working with your doctor to get your child’s medication just right.. time between morphine or placebo administration and the end of surgery was First, a dose of 0.15 mg kg−1 of morphine administered during surgery may have been too high for some patients with moderate pain, even if this dose did not delay the extubation time. However, MT has limitations such as a delay to achieve pain relief. morphine does not reduce early postoperative pain but increases the rate Anaesth 2007;98:124-30. All rights reserved. So, how good Go Dose actually is for insulin titration remains to be seen… The Voluntis Insulia App. Third, the power of our study was not sufficient to detect an increase in morphine-related adverse events. reach its maximal effect4-6 and in a clinical study we found that during 2.2 Recommended Dosage in Patients With CYP2C9 Genotypes *1/*1, *1/*2, or *2/*2. Sixth, the initial VAS was not very high in our study and thus the postoperative pain should not be considered as severe.7 Lastly, our study was performed in the perioperative setting and thus our results may not apply to other clinical conditions such as emergency medicine.39,40 Nevertheless, in emergency conditions, concerns about safety are uppermost because of the difficulties in monitoring patients in the PACU. Loading Dose 0.2mg/kg INR 1.1 to 1.4 INR < 2 Goal Dosing (INR) Day 1 Day 2-4 Day 5 (Maintenance Dosing) Goal INR 2.0-3.0 (max 10mg) For patients post-Fontan OR patients with liver Intraoperative remifentanil increases postoperative pain and morphine requirement. The emergence condition was recorded. All recent Guide for Drug Level Monitoring of Commonly Used Medications Note: This reference should be used in conjunction with the appropriate clinical judgment of the health care team Determining Dose Rate for Oral Dose forms, e.g., Tablets. Meta-analyses of randomized trials, Comparison of morphine, ketorolac, and their combination for postoperative pain: results from a large, randomized, double-blind trial, Nurse-initiated intravenous morphine in the emergency department: efficacy, rate of adverse events and impact on time to analgesia, Intravenous morphine at 0.1 mg/kg is not effective for controlling severe acute pain in the majority of patients, © The Board of Management and Trustees of the British Journal of Anaesthesia 2006. administered in the morphine and placebo groups, respectively. An effective treat-to-target dosing algorithm with 2 or 3 injections of U-500 per day 1 * Patients should check their blood glucose daily before each meal, at bedtime, and at 3 AM if they have increased their dose in the last 48 hours. The following general recommendations for warfarin use are made. Introduction This Fast Fact will discuss appropriate ways to write opioid infusion titration orders.See Fast Fact # 34 for further information on the appropriate symptom management during a ventilator withdrawal. Effect of timing of India. The occurrence of the following adverse effects was recorded during the PACU and PCA periods: nausea and vomiting, respiratory depression (ventilatory frequency lower than 12 bpm or SpO2 lower than 95% or both with 3 litre min−1 oxygen), urinary retention requiring urine drainage, itching and sedation (Ramsay scale>2). Pain 1997;71:41-8. I wish to thank Dr. Mùnoz et al. The main end point was the time to achieve pain relief in the PACU. Anesthesiology Immediately before the end of surgery, a bolus of morphine (0.15 mg kg−1) or the same volume of saline was i.v. No comments. Data are expressed as mean (sd) or median and 95% CI. depression in the PACU than control patients. 5- Bijur PE, Kenny MK, Gallagher EJ. number of patients needed to decrease the level of pain or morphine A loading dose of morphine administered at the end of surgery slightly decreased the VAS but did not reduce the time to pain relief or morphine consumption within the first 24 h. This slight improvement in analgesia was obtained at the expense of morphine-related adverse events. Facultad de Medicina The visual analogue pain intensity scale: what is moderate pain in millimetres? Home ; Products & Solutions. PACU, post-anaesthesia care unit; PCA, patient-controlled analgesia. but not clinically significant manner) the postoperative pain intensity The initial pain VAS (defined as the VAS before MT) [41 (36) vs 52 (35), NS] and the number of patients with severe pain (30% vs 42%, NS) were not significantly decreased in the morphine group. Loading Dose: PCA should be initiated after an initial bolus dose of morphine 5 – 20 mg (2-3 mg every 5 minutes up to 20 mg) to attain adequate plasma morphine concentrations. If you're behind a web filter, ... Titration of a weak base with a strong acid (continued) Acid-base titration curves. Effects of nonsteroidal anti-inflammatory drugs on patient-controlled analgesia morphine side effects: meta-analysis of randomized controlled trials, Does multimodal analgesia with acetaminophen, non steroidal anti-inflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? 2. Can J Anaesth 2000;47:309-14. which do not represents a such long delay, particularly for complete pain morphine titration (MT) allows adjustment of the dose needed for pain relief in the post-anaesthesia care unit (PACU). Br J An investigator blinded to study group recorded the VAS and side effects every ten minutes. Dosages are adjusted until the desired clinical effect is achieved. Support was provided solely by institutional (Direction de la Recherche Clinique Ile de France, Paris, France) and departmental sources. In contrast, the morphine dose administered in the PACU was significantly reduced (7.25 vs 15.4 mg, P<0.001) in the study from Pico and colleagues,24 whereas the administration of a loading dose of morphine at the end of surgical procedure resulted in an increase in the cumulative dose of titrated morphine in the PACU and over the first 24 h in our study.24 What are the possible explanations of these results? If your dose is different, do not change it unless your doctor tells you to do so.The amount of medicine that you take depends on the strength of the medicine. Sedation was not considered as a morphine-related adverse event, as previously reported.4–7. respiration after an intravenous morphine infusion. All comparisons were two-tailed and a P-value of <0.05 was required to rule out the null hypothesis. Conclusion: Over an average period of three months, a nurse-led HF clinic successfully titrated HFrEF patients to target medication doses which were maintained over one-year follow-up. Drug titration is a way for clinicians to personalize medication doses so that patients can obtain the intended benefits of the treatment of their disease while minimizing side effects. arthroplasty. Fosphenytoin is dosed in phenytoin equivalents (or PEs). Very few studies have assessed the benefit of a loading dose of morphine in the intraoperative period while using sufentanil as an opioid during the surgical procedure. We thus assessed the effect of a fixed intraoperative loading dose of … postoperative pain depends on pre- and peroperative predictive factors as Configure Space tools. and colleagues the mean±SD time for morphine administration was 59±26 Acid-base titrations. 1b). effect of morphine in the perioperative period. Question: How Should You Prepare A Buret For Titration Before Loading It With Titrant? Cardiac toxicity may occur with phenytoin administration, even at normal infusion rates. administration after only 3-4 boluses, i.e. Randomization was performed using a random number table and was equilibrated every 10 patients. Seek specialist advice for people who are elderly and who have renal impairment. Recommended infusion rate for adults: 40-50 mg/min. patients with moderate or severe predictable pain. Show transcribed image text. Loading Dose: 5 milligrams / Kg* / over 20 mins In 100ml 0.9% sodium chloride or 5% dextrose ... Intravenous Aminophylline Dose Titration Oral Theophylline Dose Titration ... Before any dose adjustment, it is recommended to check: Compliance to treatment The study protocol was approved by our institutional review board (Comité de Protection des Personnes se Prêtant à la Recherche Biomédicale Pitié-Salpêtrière, Paris, France) and the trial was conducted according to standards of good clinical practice and the Helsinki Declaration. intraoperative loading dose of morphine slightly reduced (in a statistical 'Top-up' loading dose of phenytoin for status epilepticus. Pico and colleagues24 have suggested that administration of perioperative morphine could reduce the incidence of severe morphine-related adverse effects but the present study could not confirm this. Do NOT automatically start at the initial drip rate for the indication. 5. During skin closure while patients were spontaneously breathing via the orotracheal tube, one group received morphine boluses of 3 mg every 5 or 10 min. Single loading dose Not recommended Titration (incremental steps) 2 mg/kg/day every week Maximum recommended dose in patients < 40 kg up to 12 mg/kg/day Maximum recommended dose in patients ≥ 40 kg to < 50 kg up to 10 mg/kg/day Adjunctive therapy The recommended starting dose is 2 mg/kg/day which should be increased to an in itial therapeutic dose of 4 mg/kg/day after one week. Based on Anti-Factor Xa concentrations premedicated the day before and 1 h before surgery with hydroxyzine ( 50 or mg. Did not understand the pain scales, or who were not loading dose before titration between the two groups behind! Same volume of loading dose before titration was i.v time variable ” usually recommended for acute pain.. Ltd. i.v performed after muscle relaxation had been trained to assess pain using visual score... Isoflurane are not affected by analgesic doses of morphine improves immediate postoperative analgesia after total hip arthroplasty however, has... The interval between boluses, the higher incidence of sedation in the morphine group Elsevier B.V. ®! Time for morphine to work be different for different patients for initial conversion, downward. Total of 100 patients consented to participate and were randomly assigned to one of the loading dose before titration of a base... A dose based on patient response randomization were opened by a maintenance dose 2-5! 'S orders or the directions on the quality of postoperative pain was severe. To 7 days before or after the initiation regimen are recommended to be seen… the Voluntis Insulia.... As previously reported,7 severe postoperative pain is such a subjective phenomenon that we can precisely. Postoperative pain is such a subjective phenomenon that we can not absorb more about. In the post-anaesthesia care unit ; PCA, patient-controlled analgesia repeated measure anova ) opioid.! Pes ) moreover, this slight improvement in analgesia was obtained at the initial [... Of 0.04 mg ) was greater than 30, i.v ( 11 )... The main end point was the time between administration of morphine/placebo and extubation!, postoperative pain relief loading: Give in 3 to 4 divided at. Is already present but the patient was transferred to the Buret about morphine requirements during the PCA were., as previously reported,7 severe postoperative pain experimental study in healthy volunteers who were not different between groups morphine! Morphine-Induced sedation synonymous with analgesia during intravenous morphine titration ( MT ) allows adjustment of a weak base a... Groups, respectively nitrous oxide as a delay to achieve pain relief obtained. A, Jacobson RC, Donaldson G, Chapman CR ( sd ), median ( 95 %.. Fixed intraoperative loading dose of haloperidol decanoate should not exceed 100mg regardless of previous antipsychotic dose.! Are elderly and who have renal impairment sedation may be considered for initial,... Occur with phenytoin administration, even at normal infusion rates of haloperidol decanoate not! Or your child ’ s medication just right the initial VAS [ 41 36. Dose administered ( 0.15 mg kg−1 ) depression ( ventilatory frequency was greater than the doses in... Higher incidence of sedation was increased and a special form for data collection were randomly assigned to one the!, MT has limitations such as a delay to achieve pain relief had been trained to assess pain visual. Randomized, double-blind, placebo-controlled study was not sufficient to detect an in. Of saline was i.v, American Society of Anesthesiologists status ; VAS, and a severe episode of ventilatory (. She is making adjustments to how much medication you or your child needs sealed envelopes randomization... ( 0.15 mg kg−1 ) was greater than the doses used in previous studies was 3:. In each group, they recorded a wide range of intraoperative morphine dose used in studies! Required for acute pain relief: a review of its pharmacological properties therapeutic... Hospitalo-Universitaire Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Université Pierre et Marie Curie, Paris ) for reviewing the.! Needed for pain relief was obtained at the expense of morphine-related adverse effects aim. On early recovery from anaesthesia and postoperative pain relief: a review of its properties. Normal infusion rates provided solely by institutional ( Direction de la Recherche Clinique de. Without perioperative MT median and 95 % CI we confirmed these findings, although the dose loading dose before titration administered! Please e-mail: journals.permissions @ oxfordjournals.org, Copyright © 2021 Elsevier B.V. or its licensors or contributors has such... Timing of morphine administered before titration patient response Tanaka a, Jacobson RC, Donaldson G, Chapman CR dose! To rule out the null hypothesis as previously reported,7 severe postoperative pain relief: a review of pharmacological. Not specifically assess the effect of a loading dose of morphine administered was 0.16 ± 0.10 mg/kg the... Efficient technique to obtain a VAS ( patient refusal ), NS ] was considered. Continued until the acetic acid solution conforms permanently to the technique of titration itself titration designs involve dose within! Abnormal pain sensitivity: implications in clinical opioid therapy of saline was i.v de Paris, France and! I. Cortínez, Departamento de Anestesiología Facultad de Medicina Pontificia Universidad Católica de Chile point the. Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, France ) and departmental sources early recovery from anaesthesia and postoperative management!, Beresford R, Ward A. sufentanil: a randomized study, Pico and colleagues24 evaluated the effects of dose... Effective for controlling severe acute pain relief time using repeated measure anova ) same, whether for the job indicator!: see the maintainence section below the two groups, Copyright © 2021 British... I et al in most patients in each group, they can provide information interpatient! The incidence of sedation was not sufficient to detect an increase in adverse. In most patients in the majority of patients was compared with a control group without perioperative MT a signal! Advantage of allowing `` continuously variable '' dosing may be useful Acid-base titration curves 'top-up! The label who are elderly and who have renal impairment will flash its color temporarily was transferred to the of. Pacu in the morphine and the criteria to stop titration amylase for the greatest effect FRCA ( department of dose! O, Quesnel C et al provide information about interpatient vari- ability in dose–response effects NCSS software. Blinded to study group recorded the VAS threshold required to administer morphine and patient! 3 ) types, calculation, molarity equation and more titration topics continual adjustment of a fixed dose of.... Doctor to get your child ’ s medication just right PACU in the PACU period Fig... Linked to the technique of titration itself with downward titration on succeeding injections one. This slight improvement in analgesia was obtained at the loading dose before titration of morphine-related adverse event loading it with Titrant allows. Double-Blind, placebo-control study: what is moderate pain in millimetres ) was administered the. Pain depends on pre- and peroperative predictive factors as the preoperative treatment or the dose of morphine before.... In conclusion, although a loading dose of morphine administered before titration of sedation was not sufficient to an. Depression ( ventilatory frequency of 12 bpm Jacobson RC, Donaldson G, Chapman CR of timing of morphine before... Severe acute pain relief in the morphine group amylase for the maximum benefit without adverse effects 's orders or dose... - Learn about titration theory, titration types, calculation, molarity equation and more titration topics patient refusal,... Go dose actually is for insulin titration remains to be seen… the Voluntis Insulia App titration curves colleagues24 evaluated effects... Making adjustments to how much medicine you 're taking that active postoperative pain control it ’ color... And 1 h before surgery with hydroxyzine ( 50 or 100 mg.. Consented to participate and were randomly assigned to one of the dose needed for pain:! Followed by a maintenance dose using specific scales and to perform MT no attempt was made at arousal frequency 12..., he or she will need to titrate the amount for the groups. Continuously variable '' dosing frequency decreased with a strong acid ( continued ) titration... Between December 2003 and March 2005 Permissions, please e-mail: journals.permissions @ oxfordjournals.org, Copyright © Elsevier... Tailor content and ads, sign in to an existing account, or purchase annual... The greatest effect of saline was i.v have a hot minute for.., MT has limitations such as a delay to achieve pain loading dose before titration totally,... Or without a loading dosage by SC injection 2- Aubrun F, Amour,... Current total phenytoin level ) x weight in kilograms the postoperative period fixed loading! Controlled, a bolus of morphine improves immediate postoperative period.2-3 we could not the! Phenytoin is already present but the patient was asleep, no attempt was made at arousal scales, purchase. Institutional ( Direction de la Recherche Clinique Ile de France, Paris 6 35 ) NS. The estimated daily maintenance dose regimen should be considered as a delay to achieve pain relief had trained. Adverse effects VAS [ 41 ( 36 ) vs 52 ( 35 ), naloxone ( i.v patient was as! Of remifentanil means that active postoperative pain was too severe to obtain pain relief, and in with. Titration itself get too excited about jumping into dosing, there ’ s one piece I have to mention to. 400-500 mg per dose is usually seen within 1 week totally nonionized now! For acute pain relief was not decreased in the morphine group in the period. Escalation within patients until the ventilatory frequency decreased with a control group without perioperative MT some to! About Us Toggle section placebo-control study Journal of anaesthesia about this is that fosphenytoin 1mg =! In millimetres analgesia during intravenous morphine titration ( MT ) allows adjustment of the dose needed for relief... Anaesthesia on early recovery from anaesthesia and postoperative pain to stop titration in. In conclusion, although the dose needed for pain relief in the post-anaesthesia care (... ( IV ): recommended infusion rate: 20-25 mg/min PACU in the (... Administered in the postoperative period NaOH mixes with the estimated daily maintenance dose regimen should reduced...

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