We have been using this drug in good number of cases, our practice is mainly Laparoscopic & Bariatric practice.
All theory is in text books.
We will stick to our experience only.
WE start our first bottle in OT Paracetamol drip 100 ml. I inject 20 mic in this drip which will run over 15 mins. (if injected directly IV, and fast, it can give severe Bradycardia and Hypotension augmented by induction agents, so we put in this 100 ml drip).
By the time induction is over and first drip is over, we put the other 30mcg in the next drip which is a 1000 ml Ringer Lactate, planned to go over 1 1/2 hours.
It is available in form of 50mcg in 1/2 ml amps. Also 1 ml( 100mcg) and 2 ml(200mcg) are available.
This gives an almost perfect result of steady heart rate and BP. In Indian population, I have found that even this small dose is a bit on higher side. Patient wakes up a bit late. In turn one will learn to reduce GA levels and adjust as per requirement. One has to learn this drug over some time. We have not yet mastered it.
I have not been sticking to mcg/kg regime. We have not yet come to that conclusion.
In our population , 1 mcg/kg as loading dose turns out to be very high. ( Still too early to comment)
Please give your feed back.
Regards.
All theory is in text books.
We will stick to our experience only.
WE start our first bottle in OT Paracetamol drip 100 ml. I inject 20 mic in this drip which will run over 15 mins. (if injected directly IV, and fast, it can give severe Bradycardia and Hypotension augmented by induction agents, so we put in this 100 ml drip).
By the time induction is over and first drip is over, we put the other 30mcg in the next drip which is a 1000 ml Ringer Lactate, planned to go over 1 1/2 hours.
It is available in form of 50mcg in 1/2 ml amps. Also 1 ml( 100mcg) and 2 ml(200mcg) are available.
This gives an almost perfect result of steady heart rate and BP. In Indian population, I have found that even this small dose is a bit on higher side. Patient wakes up a bit late. In turn one will learn to reduce GA levels and adjust as per requirement. One has to learn this drug over some time. We have not yet mastered it.
I have not been sticking to mcg/kg regime. We have not yet come to that conclusion.
In our population , 1 mcg/kg as loading dose turns out to be very high. ( Still too early to comment)
Please give your feed back.
Regards.