What is the role of methohexital in emergency department (ED) sedation?

Updated: Nov 06, 2018
  • Author: Arul M Lingappan, MD; Chief Editor: Erik D Schraga, MD  more...
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Methohexital is the shortest acting of the barbiturate sedatives, with a rapid onset of action (< 1 min) and a short duration of action (5-10 min). The adult dose for induction is 0.75-1 mg/kg. It also can be used as a sedative for brief procedures, in which case, it is titrated to effect. Adverse effects include hypotension (due to vasodilatation and myocardial depression with reflex tachycardia), which can be more evident in hypovolemia. It should be used with caution in hemodynamically unstable patients, starting off at lower doses (0.5 mg/kg) and titrating up slowly to sedation. [1, 4]

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