Indications: short duration surgical procedures

Cautions: respiratory depression; reconstituted solution is highly alkaline—extravasation causes tissue necrosis and severe pain; avoid intra-arterial injection; cardiovascular disease; hepatic impairment.

Contra-indications: myotonic dystrophy; breast-feeding

Side Effects: arrhythmias, myocardial depression, laryngeal spasm, cough, sneezing, hypersensitivity reactions, rash, injection-site reactions; excessive doses associated with hypothermia and profound cerebral impairment.

Dose: by IV injection in fit premedicated adults, initially 100-500 gm (4-6 ml of 2.5% solution) over 10-15 seconds, repeated if necessary according to the patient's response, after 20-30 seconds or up to 4 mg/kg.

Child, induction, 4-8 mg/kg.

By continuous intravenous infusion, as 0.2-0.4% solution, according to the patient's response.