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Just wanted to see what others had to say about this.
A particular neurosurgeon at my hospital now does only pain-related procedures. Lum-lams, cervical fusions, intradiscal electrothermy (percutaneous), etc.
His standing "orders" to anesthesia:
versed
decadron
toradol
zofran
diprivan
sux
volatile
so far, so good
.
.
.
.
.
.
absolutely no narcotics of any kind
no paralysis - pt will breath spontaneously throughout the procedure
ketamine 0.4 mg/kg q 30 minutes, max three doses.
What's interesting is that 99.9% of his pts do quite well, are easily extubated within 2-3 minutes of the dressing going on, and are very comfortable in PACU. His cases rarely go longer than two hours.
Occasionally I wonder why all pts aren't done this way?
A particular neurosurgeon at my hospital now does only pain-related procedures. Lum-lams, cervical fusions, intradiscal electrothermy (percutaneous), etc.
His standing "orders" to anesthesia:
versed
decadron
toradol
zofran
diprivan
sux
volatile
so far, so good
.
.
.
.
.
.
absolutely no narcotics of any kind
no paralysis - pt will breath spontaneously throughout the procedure
ketamine 0.4 mg/kg q 30 minutes, max three doses.
What's interesting is that 99.9% of his pts do quite well, are easily extubated within 2-3 minutes of the dressing going on, and are very comfortable in PACU. His cases rarely go longer than two hours.
Occasionally I wonder why all pts aren't done this way?