Drug effects are simplified qualitative estimates based on typical neonatal use and may vary substantially by dose, route, infusion rate, underlying physiology, and clinical context. Cardiopulmonary interactions may also be affected by concomitant medications and the degree of baseline illness.
Dosing ranges are intended to represent reasonable neonatal starting and maintenance ranges. Institutional guidelines and formularies may differ slightly from the values presented here, and local protocols should be followed when available.
Arrow magnitude is intended to reflect general tendencies within each domain; they are not quantitative comparisons between drugs or across domains.
The primary reference for this tool is
Sedation, Analgesia, and Delirium in Neonates (2025) by Gritz et al.
Anesthetic Drug Comparison
| Drug | Dose | Effects | ||||||
|---|---|---|---|---|---|---|---|---|
| Name | Units | Start | Max | BP | HR | RR | ||
| Fentanyl Analgesia |
µg/kg/hr | 0.5 | 4 | ↓ | ↓ | ↓↓ | ||
| Hydromorphone Analgesia |
µg/kg/hr mg/kg/hr |
1 0.001 |
10 0.01 |
↓ | ↓ | ↓↓ | ||
| Morphinea Analgesia |
µg/kg/hr mg/kg/hr |
20 0.02 |
200 0.2 |
↓ | ↓ | ↓↓ | ||
| Dexmedetomidine Sedation |
µg/kg/hr |
0.3 | 1.5 | ↓ | ↓↓ | = | ||
| Midazolama Sedation |
mg/kg/hr |
0.03 | 0.2 | ↓ | = | ↓↓ | ||
| Vecuronium Paralysis |
mg/kg/hr |
0.05 | 0.15 | = | = | ↓↓↓ | ||
|
aMorphine: If >150 µg/kg/hr / 0.15 mg/kg/hr is required, consider an opioid rotation.
bMidazolam: May cause severe hypotension when given rapidly or with fentanyl. |
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