ACTION & THERAPY
MEDICATION COST
Midazolam: $615- 2.5 to 7.5 mg up to 60 minutes when given intravenously.
Fentanyl: $615- 12.5 to 100 mcg up to 60 minutes when given intravenously.
Ketamine: $615- 10 to 100 mg up to 60 minutes when given intravenously.
Propofol: $615- 10 to 100 mg up to 60 minutes when given intravenously.
Ketamine with Propofol: $1200- 10/10 to 50/15 mg, up to 60 minutes when given intravenously.
EACH GUEST WILL BE MEDICALY SCREENED ONSITE PRIOR TO MicroDOSE SEDATION
The ideal agent for procedural sedation and analgesia should provide sedative, analgesic, and amnestic effects while ensuring a rapid onset and short duration of action. These properties support safe, efficient recovery and timely discharge. Procedural sedation and analgesia commonly involve combining a short-acting benzodiazepine, such as midazolam, with an opioid, such as fentanyl. Midazolam provides sedative, amnestic, and anxiolytic effects but lacks analgesic properties, which fentanyl supplements. However, several other medications may be used alone or in combination. Short-acting agents such as propofol or etomidate are suitable for sedation in healthy patients. When intravenous access is unavailable, intranasal midazolam and intranasal fentanyl offer alternative options.
For patients at risk of hypotension due to cardiac disease, dehydration, or other conditions, ketamine may be considered. Ketamine does not cause respiratory depression and may be appropriate for patients with airway complications. In patients with obesity, dosing should be based on ideal or adjusted body weight to prevent over sedation. Older patients require lower doses to minimize adverse events.
Midazolam: Midazolam is a benzodiazepine that provides sedation, anxiolysis, and amnesia.
$615- Administered intravenously, the initial dose ranges from 2.5 to 7.5 mg, whereas debilitated and older patients typically need less than 3.5 mg. Midazolam takes effect within 1 to 5 minutes when administered intravenously and within 10 minutes when administered intranasally. The peak effect occurs within 5 to 10 minutes and can last up to 60 minutes when given intravenously.
Fentanyl: Fentanyl is a synthetic opioid metabolized by the liver with analgesic and euphoric properties .
$615- Administered intravenously, the dose ranges from 12.5 to 100 mcg until the desired sedation and pain relief are achieved. Fentanyl takes effect within 1 to 2 minutes when administered intravenously, with effects lasting 30 to 60 minutes.
Ketamine: Ketamine, a dissociative anesthetic providing sedation, amnesia, and analgesia with a lower risk of respiratory depression.
$615- Administered intravenously at an initial dose of 10 to 100 mg until the desired sedation and pain relief are achieved. When administered intramuscularly, the typical dose is 25 to 75 mg, with repeat dose of 25 to 75 mg if sedation is inadequate. Intravenous administration has an onset time of fewer than 30 seconds, whereas intramuscular administration takes approximately 3 to 4 minutes. The duration of action ranges from 5 to 10 minutes when administered intravenously and 10 to 25 minutes when administered intramuscularly.
Adverse effects include emergence reactions such as hallucinations, delirium, and vivid dreams. Ketamine can also increase heart rate and blood pressure due to sympathetic stimulation, leading to higher myocardial oxygen demand. A rare but transient risk of laryngospasm exists. Coadministration of a benzodiazepine, such as $615 midazolam, at the time of the final ketamine dose, may help reduce emergence reactions and sympathomimetic effects, particularly in young adults. Ketamine should be avoided in individuals predisposed to psychotic behavior.
As an emetogenic agent, ketamine can cause vomiting, though pretreatment with $25 ondansetron or concurrent administration with $615 propofol can reduce this risk. Ketamine does not increase intracranial pressure and is considered safe for use in patients with traumatic brain injury. Other potential adverse effects include diplopia, nystagmus, and increased intraocular pressure.
Propofol: Propofol is a short-acting does not provide analgesia and is suitable for sedation in healthy patients.
$615- Propofol is administered intravenously at an initial dose of 5 to 15 mg, with additional doses of 5 to 15 mg every 2 to 3 minutes until the desired level of sedation is achieved. Onset occurs within 15 to 30 seconds, and its duration of action ranges from 3 to 10 minutes, depending on the dose.
Ketamine with propofol: Ketofol provides effective pain control with early sedation emergence.
$1200- This combination reduces ketamine-induced vomiting and emergence reactions while counteracting the hypotensive effects of propofol. A standard mixture consists of 100 mg of ketamine in 10 mL and 100 mg of propofol in 10 mL. The initial ketofol dose is 10/10 to 15/15 mg, with half of the initial dose repeated as needed to achieve adequate sedation and analgesia.