NICU:  Neurology

• Fentanyl:  A potent narcotic.  Dose is 1 - 3 mcg/kg IV.  If patient is extubated, watch respiratory status closely since apnea is commmon.  This is a great drug for procedures like chest tube placement, and is often used during ECMO.  May be reversed with naloxone at 0.1 - 0.2 mg/kg IV/ET/IM.
• Morphine:  Less potent but longer lasting than fentanyl.  Dose is 0.05 - 0.2 mg/kg IV.  Also a potential cause of apnea, and also reversible with naloxone.
• Tylenol:  May be used for mild pain in the infant with established enteral intake.  Dose is 15 mg/kg PO/PR.  Liver toxicity is rare at normal dosages.

• Midazolam (Versed):  A potent short acting benzodiazepine.  May cause respiratory depression or hypotension, so monitor patient closely during use.  Usual dosage is 0.05 - 0.1 mg/kg IV/IM.

Chloral Hydrate:  Occasionally used in older infants with established enteral intake.  Dose is 25-50 mg/kg PO/PR.  Not useful for painful procedures, but great for CT scans and BAER screens.