Staldol Dosage/Direction for Use

Butorphanol has factors to be considered in determining the dose are age, body weight, physical status, underlying pathological condition, use of other drugs, type of anesthesia to be used, and surgical procedure involved. Use in the elderly, in patients with hepatic or renal disease, or in labor requires extra caution. The following doses are for patients who do not have impaired hepatic or renal function and who are not on CNS active agents.
Pain: Intravenous: The usual recommended single dose for IV administration is 1 mg repeated every 3 to 4 hours as necessary. The effective dosage range, depending on the severity of pain, is 0.5 mg to 2 mg repeated every 3 to 4 hours.
Intramuscular: The usual recommended single dose for IM administration is 2 mg in patients who will be able to remain recumbent, in the event drowsiness or dizziness occurs. This may be repeated every 3 to 4 hours. There are insufficient clinical data to recommend single doses above 4 mg.
Both expected efficacy and adverse reaction should be considered in dosage adjustment. The dose of this drug recommended for elderly patients, patients with hepatic or renal impairment should generally be half the recommended adult dose (0.5 mg IV and 1.0 mg IM). Repeat doses should be determined by the patient's response rather than at fixed intervals, but will generally be no less than 6 hours apart.
Use as Preoperative/Pre-anesthetic Medication: The preoperative medication dosage should be individualized. The usual adult dose is 2 mg IM, administered 60-90 minutes before surgery. This is approximately equivalent in sedative effect to 10 mg morphine or 80 mg meperidine.
Use in Balanced Anesthesia: The usual dose is 2 mg IV shortly before induction and/or 0.5 to 1.0 mg IV increments during anesthesia. The increment may be higher, up to 0.06 mg/kg (4 mg/70 kg), depending on previous sedative, analgesic and hypnotic drugs administered. The total dose of this drug will vary; however, patients seldom require less than 4 mg or more than 12.5 mg (approximately 0.06 to 0.18 mg/kg).
Opioid, including this drug, may not produce appropriate analgesic effect for every patient or every state during surgery. Analgesic fail during induction anesthesia can be judged to be general sympathetic nerve negative. Therefore, if heartbeat or blood pressure is continuously increased, intensive inhalation anesthetic or another IV should be considered.
Labor: In patients at full term or without fetal distress in early labor a 1-2 mg dose IV or IM may be administered and repeated after 4 hours. Dosage titration should be based on concurrent analgesics, sedatives, expected time of delivery and response of the first administration. If concomitant use of this drug with drugs that may potentiate its effects is deemed necessary, the lowest effective dose should be employed.