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Speaking as a surgeon (peds plastics), it is insane to me that your attendings are letting the surgeon dictate your anesthetic plan.
In my practice (and granted, I know my anesthesiologists very very well) I let the anesthesia resident and attending know what my surgical plan is, my (realistic) duration of the case, and what the patient position will be and then I let them do their thing. Once in awhile I will suggest an LMA over ETT, but ultimately it’s their call. And I always let them be the ones to volunteer just masking a patient while I do a quick excision.
My logic is that its your (anesthesiology) case from an anesthesia perspective, and I don’t want to have to worry about two specialty’s worth of issues while I’m operating. I’m a big fan of engaging all the brain power in the room in their respective roles.
In my practice (and granted, I know my anesthesiologists very very well) I let the anesthesia resident and attending know what my surgical plan is, my (realistic) duration of the case, and what the patient position will be and then I let them do their thing. Once in awhile I will suggest an LMA over ETT, but ultimately it’s their call. And I always let them be the ones to volunteer just masking a patient while I do a quick excision.
My logic is that its your (anesthesiology) case from an anesthesia perspective, and I don’t want to have to worry about two specialty’s worth of issues while I’m operating. I’m a big fan of engaging all the brain power in the room in their respective roles.