Strategies for Surgeons that Should Have Been Pathologists

[Aether2000]

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Yes, I am aware there are some surgeons that are through lack of skills or habit incapable of operating on anything that doesn't resemble a cadaver, but I am soliciting advice for options in handling this type of surgeon and being able to extubate within a reasonable amount of time. Some surgeons are upset when there is focal muscle contraction response to their use of electrocautery of the multifidus muscles and demand the patients be "completely paralyzed from skin to skin". The neuro surgeries do not involve electrophysiological monitoring and are 30-120 minutes. So how do you best handle this?

 

[periopdoc]

The patient is always "fully paralyzed sir"

 

[pjl]

Use full dose relaxant until end. When he puts down knife, give Sugammadex. Walk out door in ~3 minutes.


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[Aether2000]

Thanks! We do not yet have sugammadex in this outpatient surgery center....I will request it.