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Hi Alok,

We use Fentanyl infusion on our unit, we start with 1 ug/kg/h and titrate depending on the effect. No major side effect experienced (apart from respiratory depression), but we see withdrawal if used for longer period. Most frequently given for postop pain/PPHN etc.


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We USE clonidine infusion (1.5microgr) 2 - 3 days before we stopp fentanyl infusion if duration of fentanyl was longer than 4-5 days. Almost no withdrawl problems, reduction of clonidine 2-3 days after fentanyl was stopped


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1-4 ug/kg/h infusions, usually the lower end of that spectrum, titrating by 0.5 to 1 to effect.  Obviously respiratory depression is an issue, but these drips are almost exclusively used in intubated patients so less of a concern.  Less uniform practice in my group, historically have used methadone or morphine to come off high dose infusions, but we're increasingly using dexmedetomidine for much the same reason/effect as @frvg666 uses clonidine when coming off larger exposures. 

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