1.5-2.5 mg/kg

Lipid Emulsion

Bacterial growth- change syringe q 6 hrs

Sodium Metabisulfate preservative may cause allergy 

Not a chiral compound 

Do not mix with other drug in same syringe due to oil droplets causes precipitation 

Burns on injection 

Cardiovascular protective

Injecting into artery does no harm

Inhibits HPA axis which can last up to 8 hrs 

Increase RR

Extensive Myoclonus with some ECG activity- be careful in Sx pts 

Fast on Fast off 

Dependence

Not Neuroprotective

Elderly can have significant cognitive decline

Mild muscle relaxant 

Syngersitic effect with ETOH, barbs

Flumazenil reversal 

Mild HPA depression 

50% first pass effect 

40 hr duration of action

Active metbolites that can cause sedation 6-8 hr later and last for 48-96 hrs 

Last forever in cirrhotics 

Increased age=increased sensitivity 

8-15 mcg/kg

See effects with 2 min of admin 

Benzo may outlast your reversal 

Not available in the US

Hangover effect

Intraarterial injection causes gangrene 

Drips are not practical due to context sensitive 1/2 time 

Great SNS effect

Emergence delirium is dark and morbid

Mild LA properties

Neuraxial analgesia controversial 

Significant First Pass effect 

Can be used with propofol in TIVAs 

1-2 mg/kg IV

4-8 mg/kg IM 

Atipamezole is specific reversal 

No respiratory depression

Easily arousable 

HYPOTENSION and BRADYCARDIA