Continuous Opioid Infusion Management Guidelines. (For detailed information regarding continuous opioid infusion prescribing and management refer to local 12 Mar 2009 For example, the range for a HYDROmorphone basal infusion dose was 0.1 to 0.5 mg/hour, and there was no guidance for selecting Opioid Infusion Guidelines for. Palliative Care. Leslie N. Schechter, Pharm.D. Clinical Pharmacy Specialist. Barbara Lineham, RN, MSN. Medical/Pain Clinical 3 Nov 2012 The opioid infusion should be prescribed according to the guidelines, including infusion rate, bolus size and frequency and adjuvant medication. Morphine is the preferred opioid in most circumstances. Oxycodone, Pethidine or Hydromorphone are alternatives. Morphine. Add 0.5 mg/kg to a total of 50 mL diluent of choice (any IV maintenance solution of electrolytes and/or glucose) to make infusion. Recommended bolus for pain or painful procedures: 1-2 mL (10-20 microgram/kg) of infusion at intervals of no less than 10 minutes. First, before starting an opioid infusion, calculate an equianalgesic dose of currently used opioids; then convert this to an equianalgesic basal rate. (Example: After doing the conversion from IV dose to PO dose, consider decreasing the PO dose by 20-30% as analgesia requirements decrease. This oral dose can be given PRN. in opioid-tolerant patients (those who have received opioids for approximately 7 days or more). Cancer Treat Rep. 1986 May;70(5):575-81. I.v. infusion of opioids for cancer pain: clinical review and guidelines for use. Portenoy RK, Moulin DE, Rogers A,9 May 2016 The 2013 SCCM guidelines advocate a pain-first approach to sedation, starting with an opioid infusion as the first-line approach to sedation.