How much DIPRIVAN?

[adean]

Is there an amount that Diprivan can only be given up to? There was a PT in ICu and she was on 50cc/hr, she was fully awake! I thought this was alot and she should have been comfortable.

Thanks April

[lifeLONGstudent]

our usual max is 80 - 100 micrograms/kg/min

cc/hr depends on their weight.

[cardiacRN2006, ADN, RN]

I have given a lot more than that..

You give "a lot more" than 50 mL/hr?

I give a lot more than 50mcgs, but 50mL/hr is half a bottle. Although not unheard of for patients to receive and tolerate a lot of sedation, to say that you give a lot more than half a bottle is odd.

We run propofol at mcg/kg/min, but I also see people saying they give it at ml/hr. I find that odd.

[mosin46]

it's a titration. so while there is a limit i've probably never seen it. some people are refractory to it. usually the higher the % of muscle mass the faster it gets chewed up. alcoholics also can take quite a high amount. had a guy on 200 m/k/m for a month and he was 4 pointed and never quite fighting the whole time he was on the vent. gave 1 guy 10 of ms iv fast and 50 cc of propofol for a knee dressing change. he never closed his eyes. i've seen 250lb steel workers quite breathing after 2 of versed.the dose of meds required for sedation, propofol or anything else, is so unpredictable at times and only approximates what the book says that caution, experience,being prepared and good communication with your docs are your best bets .

[cardiacRN2006, ADN, RN]

You gave 50mL for a knee dressing change?? If I gave 50mL IVP, I would be fired and reported to the BON.

[meandragonbrett]

Need to be careful with the diprivan. We monitor daily lactic acid and CPK and will switch to Fentanyl/Versed when they start creeping up.

[bellarn75]

My unit's policy is 50 mcg/kg/min max. We titrate to rass score -1 along with morphine or fentanyl gtt.

[mrsituation]

When I worked in a Transplant ICU, I found that pt's with a hx of ETOH use/abuse required higher doses of Diprivan sedation; also it is a weight based drug (mcg/kg/min) We also considered doses of higher than 50mcg/kg/min anesthesia; but on the other hand, do what U have to do to keep you and your patient happy. If the patient is happy; then the Nurse is also happy. LOL:cheers:

[JohnW]

I think our offical policy is up to 50mcg/kg/min, but I've had a number of people that we've needed 80mcg or more. The fact that someone is pretty awake on 50mcg is not too suprising - IME, some people can just plain handle a lot of sedation meds, espically if they are that aggitated sort at baseline. The big concern that I've seen in real life is whether someone's BP can handle the drug, espically when you first start it up. This is why we, as RNs, never offically push prop at my instution. However, in semi-emergencies (the patient is going wild and is a danger to themselves) some nurses may bolus a couple CCs if the patients's BP is OK.

In terms of giving narcs and benzos - this is not always appropriate for some populations (neuro patients) or anyone you need to wake up fast and often.