Dosing Considerations for Fentanyl and Propofol

Fentanyl and Propofol Administration

For a patient, an initial IV bolus of fentanyl 100-150mcg (approximately 1μg/kg based on pharmacokinetic mass) can be administered, followed by propofol, with supplemental doses of 25μg of fentanyl given every 2-5 minutes until adequate sedation is achieved, and a continuous infusion of 25-300μg/h (0.5-5μg/kg/h based on adjusted weight) can be used for maintenance, as recommended by the European Heart Journal 1
The European Society of Gastroenterology suggests that fentanyl should be administered first, and that supplemental doses of 25μg can be administered every 2-5 minutes until adequate sedation is achieved, with monitoring for respiratory depression, which is the major adverse effect of this combination 2, 3

The European Heart Journal recommends continuous monitoring of oxygen saturation, blood pressure, and heart rate, and having naloxone readily available for reversal of opioid effects if needed, as well as being prepared for possible airway management as the combination can cause significant respiratory depression 1, 2
The American Gastroenterological Association suggests having naloxone readily available for reversal of opioid effects if needed, and being prepared for possible airway management as the combination can cause significant respiratory depression 2, 3