Anyone do dual prop/IV + volatile anesthesia
I keep taking over cases where people have full gas and a good amount of prop running. Is this a thing?
I get the 0.3 MAC with prop at 100-150 mcg/kg/min, where they are doing "dirty TIVA" esp in places without any neuro activity monitoring and they want to monitor SSEP/MEPs
But what i keep seeing is prop at like 20-100 and sevo at MAC 0.8-1.4? Just last week, someone had their sevo at 1.3 MAC (not percent), and prop at 50... for "balanced anesthesia"?
Am i out of the loop? If I run gas at 0.8+ mac, i rarely run propofol gtt (maybe precedex or ketamine as an adjunct but that's less for hypnotics and more for pain/post op aggitation). For smooth wake, i just turn off gas and bolus propofol the last 10-15 min.
(I'm talking about adults btw, I know very little with pedi. And i totally get using prop to decrease volatiles but prop in addition to full mac seemed excessive but it appears it's not uncommon practice from the comments)