Recofol N

8 to 18 Years Old

Induction of general anesthesia:
Recofol N is not recommended for use in children less than 3 years of age.

When used to induce anesthesia in children, it is recommended that Recofol N be given slowly until the clinical signs show the onset of anesthesia. The dose should be adjusted for age and/or weight. Most patients over 8 years of age are likely to require approximately 2.5 mg/kg of Recofol N for induction of anesthesia. Under this age the requirement may be more. Lower dosage is recommended for children of ASA grades 3 and 4.

Maintenance of general anesthesia:
Recofol N is not recommended for use in children less than 3 years of age.

Anesthesia can be maintained by administering Recofol N by infusion or repeat bolus injection to maintain the depth of anesthesia required. The required rate of administration varies considerably between patients but rates in the region of 9 to 15 mg/kg/hour usually achieve satisfactory anesthesia.

Sedation during intensive care:
Recofol N is not recommended for sedation in children as safety and efficacy have not been demonstrated. Although no causal relationship has been established, serious adverse events (including fatalities) have been observed from spontaneous reports of unlicensed use and these events were seen most often in children with respiratory tract infections given doses in excess of those recommended for adults.

18 to 55 Years Old

Induction of general anesthesia:
Recofol N may be used to induce anesthesia by slow bolus injection or infusion.

In unpremedicated and premedicated patients, it is recommended that Recofol N should be titrated (approximately 40 mg every 10 seconds in an average healthy adult by bolus injection or infusion) against the response of the patient until the clinical signs show the onset of anesthesia.

Most adult patients aged less than 55 years are likely to require 1.5 to 2.5 mg/kg of Recofol N. The total dose required can be reduced by lower rates of administration (20-50 mg/minute). Over this age, the requirement will generally be less. In patients of ASA grades 3 and 4, lower rates of administration should be used (approximately 20 mg every second).

Maintenance of general anesthesia:
Anesthesia can be maintained by administering Recofol N either by continuous infusion or by repeat bolus injections to maintain the depth of anesthesia required.

Continuous infusion: the required rate of administration varies considerably between patients but rates in the region of 4 to 12 mg/kg/hour usually maintain satisfactory anesthesia.

Repeat bolus injections: if a technique involving repeat bolus injections is used, increments of 25 mg to 50 mg may be given according to clinical need.

Sedation during intensive care:
When used to provide sedation for ventilated adult patients undergoing intensive care, it is recommended that Recofol N be given by continuous infusion. The infusion rate should be adjusted according to the depth of sedation required but rates in the region of 0.3 to 4.0 mg/kg/hour should achieve satisfactory sedation.

55 to 65 Years Old

In elderly patients the dose requirement for induction of anesthesia with Recofol N is reduced. The reduction should take account of the physical status and age of the patient. The reduced dose should be given at a slower rate and titrated against the response. Where Recofol N is used for maintenance of anesthesia or sedation the rate of infusion or target concentration should also be reduced. Patients of ASA grades 3 and 4 will require further reductions in dose and dose rate. Rapid bolus administration (single or repeated) should not be used in the elderly as this may lead to cardiorespiratory depression.