Drug | Doses for initial pain control in the PACU* | Approximate dose ranges after initial pain control has been achieved¶ |
Morphine |
<6 months | - 0.025 to 0.03 mg/kg IV every 10 to 15 minutes, up to 3 to 4 doses as needed
| - 0.03 to 0.05 mg/kg IV every 3 to 4 hours as needed
|
≥6 months, children and adolescents | - 0.03 to 0.05 mg/kg IV approximately every 10 to 15 minutes, up to 3 to 4 doses as needed
| - 0.05 to 0.1 mg/kg IV every 3 to 4 hours as needed, maximum single dose 4 mg
|
HydromorphoneΔ | - 0.003 to 0.005 mg/kg IV every 10 to 15 minutes up to 3 to 4 doses as needed
| - <20 kg: Not generally recommended
- ≥20 kg or 7 to 12 years: 0.005 to 0.015 mg/kg IV every 3 to 6 hours as needed
- ≥50 kg (adolescents): Flat dose: 0.2 to 0.6 mg IV every 3 to 6 hours as needed, maximum 0.8 mg
|
Fentanyl◊ | - Moderate pain: 0.025 to 0.5 mcg/kg slow IV push every 5 to 10 minutes as needed
- Severe pain: 0.5 to 1 mcg/kg slow IV push every 5 to 10 minutes, up to 4 doses as needed
| - Not recommended outside of PACU, ICU, or ED
|