In adult post‑intubation sedation/paralysis, what is the fentanyl dosing and administration plan?

• A. 50 mcg SLOW push IV/IO
• B. 100 mcg SLOW push IV/IO (Repeat 1x in 20 min)
• C. 200 mcg IN slow push
• D. 25 mcg/kg IV/IO

Answer: (B)

In adult post‑intubation sedation/paralysis, use a measured fentanyl bolus to provide analgesia and blunt sympathetic responses, then titrate as needed. A plan of administering 100 mcg slowly IV/IO delivers rapid analgesia with manageable hemodynamics and allows for careful titration. If agitation or pain persists after about 20 minutes, a repeat dose is appropriate, giving you a controlled way to reach the desired level of sedation without overshooting. This approach relies on IV/IO delivery for predictable onset and duration, and slow administration to reduce side effects such as respiratory depression and chest wall rigidity. Smaller doses, non‑IV routes like intranasal, or weight‑based large doses (for example, 25 mcg/kg) are not as reliable or safe in this setting.