The doc I was with in December did a lot of backs with monitoring which required .5 mac. Always used Precedex. 100mcg put in a 50 CC NS bag. Gave 10 mcg during induction with the drip set up for between 8-14 ml's hour depending on his mood. Induction with 170 or so mg propofol, succ with a nibble of roc beforehand, 2mg versed, and some fentanyl. Doc had been doing neuro cases long enough that he would know when the surgeon was about to advance to a more painful/stimulating part of the case, and he would slip a biscuit of versed, fentanyl, and maybe some roc. Very light with the roc as not to mess up the monitoring, but enough to make him feel comfortable the patient wasn't going to move as the surgeon is swimming through the cauda equina. Patients would always extubate smoothly, snore being pushed to recovery, but answer questions/follow orders as needed. Sometimes we would use precedex drip with propofol/ketamine infusion with the same result. To correct low BP, we had premixed a 100cc bag with a cc of phenylephrine. Filled up a 10cc syringe for the case. Keep the rest for next patient. BP start to drop, slip a cc or two in. Dude was a jedi.