Induction regimen

[DrRobert]

Academic residency programs seem to stress the importance of tailoring your anesthetic to each case/patient, but sometimes it seems like overkill.

So my question is for the private practice docs:

How often do you deviate from the traditional Propofol, Sux/Roc, Des/Sevo, Fentanyl induction for your general anesthesia cases? (excluding cardiac and other non-routine cases)


It seems reasonable to me that >95% of cases could be done smoothly with this regimen.

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[The_Sensei]

Academic residency programs seem to stress the importance of tailoring your anesthetic to each case/patient, but sometimes it seems like overkill.

So my question is for the private practice docs:

How often do you deviate from the traditional Propofol, Sux/Roc, Des/Sevo, Fentanyl induction for your general anesthesia cases? (excluding cardiac and other non-routine cases)


It seems reasonable to me that >95% of cases could be done smoothly with this regimen.

>95% of these cases are done smoothly with this regimen.

 

[IceDoc]

>95% of these cases are done smoothly with this regimen.

Quite true. You just can't become complacent and forget the patients that truly do need a different induction technique. I did internship at a hospital where the surgery and anesthesiology folk were 100% private; and I saw that even they did things like awake intubations and using ketamine for pericardial tampenade.

 

[The_Sensei]

Quite true. You just can't become complacent and forget the patients that truly do need a different induction technique. I did internship at a hospital where the surgery and anesthesiology folk were 100% private; and I saw that even they did things like awake intubations and using ketamine for pericardial tampenade.

Which, as noted above, represent <5% of the typical case load.

 

[Planktonmd]

Yes!
Same regimen, except when I feel like doing something fancy.

 

[VolatileAgent]

one syringe of orange stuff... some blue stuff... one syringe of white stuff... one syringe of red stuff....

 

[EtherMD]

Academic residency programs seem to stress the importance of tailoring your anesthetic to each case/patient, but sometimes it seems like overkill.

So my question is for the private practice docs:

How often do you deviate from the traditional Propofol, Sux/Roc, Des/Sevo, Fentanyl induction for your general anesthesia cases? (excluding cardiac and other non-routine cases)


It seems reasonable to me that >95% of cases could be done smoothly with this regimen.

Yes. Only use SUX when indicated or very short cases (muscle pain).
The other 5% I use Etomidate. Almost never use ketamine. Adjust Propofol dose accordingly.