If WAT-1 >5 and unable to wean: give rescue doses,
consider adding clonidine patch and/or transitioning to
intermittent methadone and/or lorazepam
Long term wean
o Conversion to intermittent dosing: give dose for 24-48 hours
before any subsequent wean is made
o Goal to decrease drug by 10-20% of the original total dose per
day
o If withdrawal symptoms develop, then stop weaning for 24
hours
o If withdrawal symptoms don’t improve or worsen, then
increase opioid/benzodiazepine to previous dose or consider
adding clonidine patchX. Sample Sedation Algorithms
The literature supports sedation and analgesia algorithms in neonatal and
pediatric intensive care units, however there is no consensus as to the agents
or protocol to implement. The figures at the end of this chapter are examples of
sedation and analgesia algorithms used at a high volume tertiary care center.
They are meant for general suggestions for algorithms to follow, not absolute
recommendations, as they have not been validated scientifically.