What fentanyl IV infusion rates provide ICU analgesia?

Fentanyl IV infusion for ICU analgesia: 25 to 200 mcg/h (0.7 to 3 mcg/kg/h). Bolus dosing: 0.35 to 1.5 mcg/kg IV. Fentanyl preferred in hemodynamic instability (less histamine release than morphine), renal failure (no active metabolite accumulation), and when rapid titration is needed (short context-sensitive half-time at low doses).

When does fentanyl context-sensitive half-time increase dangerously?

Fentanyl context-sensitive half-time increases significantly with prolonged infusion (>12 hours at high doses): from 15 min (short infusion) to 300+ min (multi-day ICU infusion). This makes weaning difficult in prolonged ICU stays. Remifentanil is preferred when rapid offset needed regardless of infusion duration (t1/2 alpha 3 to 5 min, ester hydrolysis).

Fentanyl Equianalgesic ICU Dosing Calculator

Calculate fentanyl continuous infusion rates equivalent to other opioids for ICU analgesia, with dose titration based on CPOT/NRS scores and conversion between IV morphine, hydromorphone, and fentanyl patch.

⚕ Clinical Disclaimer: These calculators are for educational and reference purposes only. Always verify results with qualified clinical judgment and current clinical guidelines. Do not use as a sole basis for medical decisions.

How It Works

Each component has a specific meaning:

Conversion between IV morphine — The conversion between iv morphine recorded for the scenario being assessed.
Hydromorphone — The hydromorphone recorded for the scenario being assessed.
Fentanyl patch — The fentanyl patch recorded for the scenario being assessed.

Note: Interpret the fentanyl icu dosing result against the thresholds and context described above.

How to Use

Enter the conversion between IV morphine, hydromorphone, fentanyl patch for the scenario you are assessing. Calculate fentanyl continuous infusion rates equivalent to other opioids for ICU analgesia, with dose titration based on CPOT/NRS scores and conversion between IV morphine, hydromorphone, and fentanyl patch. Use the fentanyl icu dosing result to inform your calculation.

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