Pain medication dosing

[LeenaJoseph]

Hello,

I work in a level III NICU , My question is what is the maximum dosage of morphine and versed drip if you are using it for your micro preemies ? And does anybody uses morphine , versed and Fentanyl drip together ? Is there any literature out there to support high dosing of drips . Our new group of Dr's seem to use very high dose of morphine and versed drip doses and not going by neofax .

[umcRN, BSN, RN]

we primarily start with morphine and add versed if necessary. We start low, like 0.02mg/kg/hr and increase as necessary. If more than 6 PRNs are needed in a 12 hour period we go up by 20% the original dose. Many of our micro's aren't sedated unless their wild, obviously uncomfortable, post surgery (nec, PDA) or critically sick and need sedation to maintain hemodynamics.