What is the role of fentanyl in pediatric sedation?

Updated: May 08, 2018
  • Author: Wan-Tsu Wendy Chang, MD; Chief Editor: Ted Rosenkrantz, MD  more...
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Fentanyl is a synthetic opioid that is 75-200 times more potent than morphine sulfate and has a much shorter half-life. It has less hypotensive effects than morphine does and is safer in patients with hyperactive airway disease because there is minimal to no associated histamine release. By itself, fentanyl causes little cardiovascular compromise, although addition of benzodiazepines or other sedatives may result in decreased cardiac output and blood pressure.

Because of its short duration of action (30-60 minutes) and easy titratability, fentanyl is an excellent choice for pain management and sedation. Its onset of action is immediate after IV administration. It is easily and quickly reversed by naloxone.

In children younger than 6 years, fentanyl is given as 0.3-1.5 µg/kg/dose by slow IV push (over 1-2 minutes); this may be repeated every 1-2 hours. In children aged 6 years and older, it is given as 1-5 µg/kg/dose by slow IV push (over 1-2 minutes); the IV dose may be repeated every 1-2 hours (the dose may range from 1 to 10 µg/kg/dose).

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