No movement during MAC

Was in a case with a vascular surgeon the other night. The patient was an elderly man undergoing L AVF revision. My attending wanted Ketofol infusion so I started it, gave precedex in the beginning of the case, a little fentanyl before incision. Patient was out the entire time, snoring but would twitch his left arm occasionally. It was obviously unconscious movement but the surgeon was getting upset, talking sarcastically about how great the anesthesia is. I tried deepening the anesthetic to the point I had to jaw trust the patient. I guess the patient twitched at the wrong time and the surgeon flipped his shit and called for my attending who just suggested giving versed. As I was pushing versed, surgeon said he was done.

I figured the twitching was likely from the ketamine. Anything else that could have been done in this situation?