INFUSION RATE

CALCULATIONS
REVIEW ANESTHESIA
DRUG DOSE
 ATROPINE
• Dose- 0.4 to 0.6 mg IM 45 to 60
minutes prior to anesthesia
 PROMETHAZINE
• Dose- 25 to 50 mg IM, slow IV, rectal,
or PO 30 minutes prior to anesthesia
 DIAZEPAM
• Induction
– Dose- 0.3 to 0.5 mg/kg slow IV
• Muscle relaxation
– Dose- 1.0 to 2.0 mg slow IV prn
 KETAMINE
• Induction
– Dose- 1.0 to 2.0 mg/kg slow IV
• Maintenance
– Dose- 30 to 90 mcg/kg/min IV drip
 MIDAZOLAM
• Induction
– Dose- 0.15 to 0.4 mg/kg/ slow IV
 MORPHINE
• Maintenance dose 2 to 20 mcg/kg/ IV
drip
 NALOXONE
• Overdose - 1.0 to 2.0 mg slow IV q 5
minutes up to 3 times
• Maintenance - 400 mcg IV drip over
one hour
 FLUMAZENIL
• Reversal of conscious sedation
– Dose- 0.2 to 1.0 mg slow IV q 20
minutes @ 0.2 mg/min
• Overdose
– Dose- 3.0 to 5.0 mg slow IV @ 0.5
mg/min
 INTRAVENOUS INFUSION
FORMULA
• Set up

50ml x 2400mcg x 60gtts

400mg 1 min 1ml
 INTRAVENOUS INFUSION
FORMULA
• Reduce

1ml x 2.4mg x 60gtts

8mg 1min 1ml
 INTRAVENOUS INFUSION
FORMULA
• Cancel
1 x 2.4 x 60gtts
8 1min 1
 INTRAVENOUS INFUSION
FORMULA
• Multiply
144gtts
8min

Can this be reduce ?

 INTRAVENOUS INFUSION
FORMULA
• Reduce
144gtts
8min
to
18gtts
1min
 PR0BLEMS
• Patient is a 22 year old, 70 kg male
with a GSW to the left thigh. Pulse 90
s/r, resp 18 d/r, BP 110/78, temp 98.4.
Patient is in fair condition and is
stable
 PR0BLEMS
• What dose and route for
preanesthetic atropine will you give?
 PR0BLEMS
• preanesthetic atropine, 0.5mg IM
 PR0BLEMS
• What is the dose and route for
preanesthetic promethazine for this
patient?
 PR0BLEMS
• preanesthetic promethazine, 50 mg
IV slow
 PR0BLEMS
• What is the IV induction dose of
diazepam for this patient?
 PR0BLEMS
• IV induction dose of diazepam, 35mg
• What route/rate?
 PR0BLEMS
• route/rate, IV @ < 5mg/min
 PR0BLEMS
• With an infusion setup of 2.0 grams
of ketamine in a 1000ml bag of 0.9%
NaCl connected to a microdrip
administration set what is the
minimum maintenance rate in
gtts/min?
 PR0BLEMS
• 63gtts/min
 PROBLEMS
• What is the maximum infusion rate?
Multiply minimum by 3.
 PROBLEMS
• 189gtts/min
 PR0BLEMS
• How long will this same infusion
setup last at the maximum
maintenance rate (must know how
many drops are in the bag)?
 PR0BLEMS
• Take the ml in the bag X the drop of
the administration set = drops in bag.
 PR0BLEMS

• 1000ml X 60gtts = 60,000gtts

 PR0BLEMS

• Then divide 60,000gtts by 189gtts.

 PR0BLEMS
• 317minutes (About 5 hours and 28
minutes )
 PR0BLEMS
• At the minimum maintenance rate?
 PR0BLEMS
• At the minimum maintenance rate?
• Just multiply maximum by 3
 PR0BLEMS
• Just multiply maximum by 3 = 960
minutes
 PR0BLEMS
• A 50ml bolus from the maintenance
bag will give the patient how much
Ketamine?
 PR0BLEMS
• 2000mg divided by 1000ml = 2mg per
1ml
 PR0BLEMS
• 2mg X 50ml = 100mg Ketamine
 PR0BLEMS
• What is the dose and rate of
flumazenil for a benzodiazepine
overdose in this patient?
 PR0BLEMS
• The dose and rate of flumazenil for a
benzodiazepine overdose, 5mg IV @
0.5mg/min
 PR0BLEMS
• What is the maximum amount of 2%
lidocaine with epinephrine that can
be given to this patient ( in ml )?
 PR0BLEMS
• The maximum amount of 2%
lidocaine with epinephrine that can
be given to this patient ( in ml ),
490mg.
• How many ml?
 PR0BLEMS
• 2% lidocaine with epinephrine =
20mg per ml.
• 490mg divided by 20mg per ml = how
many ml?
 PR0BLEMS
• 24.5 ml