1Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
2Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
3Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Korea
4Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
5Department of Internal Medicine and Digestive Disease Center, Seoul Medical Center, Seoul, Korea
6Department of Internal Medicine and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
7Department of Pediatrics, Seoul Metropolitan Children’s Hospital, Seoul, Korea
8Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
9Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
10Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
11Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Korea
12Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: JML, JKL, BWK; Data curation: YP, JMP, HHC, JYB; Formal analysis: HJP, JWC; Investigation: JML, YP, JYB; Methodology: JMP, SYS, JHL; Project administration: HJP, JWC, JKL, BWK; Resources: YP, JYB, SYS, JHL; Software: JWC, HKC, HHC; Supervision: JKL, BWK; Validation: HKC, SYS, JWC; Visualization: HJP, HKC, HHC; Writing–original draft: JML; Writing–review & editing: all authors.
Drug | Initial dose | Repeat dose | Onset | Duration | Pros | Cons | Reversal agent | Analgesic effect |
---|---|---|---|---|---|---|---|---|
Etomidate | 0.15 mg/kg | 0.05 mg/kg q 2 min | 30–60 sec | 3–5 min | Fast onset of action | Myoclonus | - | - |
Hemodynamic stability | Adrenal suppression | |||||||
Low risk of respiratory depression | ||||||||
Dexmedetomidine | 1 μg/kg | Continuous infusion of 0.2–0.7 μg/kg/hr | 1 min | 2–4 hr | Ability to preserve spontaneous ventilation | Slow onset and slow offset of effect | Atipamezole | ++ |
Remimazolam | 0.05–0.075 mg/kg | 0.2 mg/kg | 30–60 sec | 3–5 min | Fast onset of action | Flumazenil | - | |
Short recovery time | ||||||||
Ketamine | 1–2 mg/kg IV | 0.5 mg/kg q 2 min | 30–120 sec | 15–30 min | Analgesic effect | Hallucination | - | ++ |
Ability to preserve spontaneous ventilation | Increased salivation | |||||||
Fospropofol | 6.5 mg/kg | 1.6 mg/kg | 4–8 min | 2–16 min | Aqueous formulation | Currently not available | - | - |
Remifentanil | 0.1–0.3 μg/kg | 0.025–0.1 μg/kg/min | 30–60 sec | 3–6 min | Hemodynamic stability | Naloxone | +++ | |
Low risk of respiratory depression | ||||||||
Short recovery time | ||||||||
Oliceridine | 1–3 mg | 1 mg | 5–20 min | 1–3 hr | No dose adjustment | Slightly slow onset | Naloxone | +++ |
Low risk of respiratory depression |
-, none; +, weak; ++, moderate; +++, strong; IV, intravenous.