Everyone seems to have a different technique for emergence. Could the CRNAs out there share their technique to wake patients after general anesthesia, especially GETA. I know some CRNAs who like to transiton from volatile gas to a propofol drip towards the end of the case, while some slowly decrease the gas just before the case ends. I've also seen in clinicals where a couple of CRNAs like to have the patient spontaneously breathing well before decreasing the gas. Could anyone discuss their techniques and the advantages and disadvantages?
Turn off the sevo while the surgeons are closing (you have to know how long your surgeons take to close) go to SIMV, turn on the N2O 1.5L and O2 at 1L. When you want to gas more Sevo off, turn volumes of N2O to 8 and O2 to 6.5. (It will blow off more Sevo). Then after the dressing is on, (your residual Sevo will be low, .2 or .1) then turn the N2O off. Wait for a few min. until nitrous is gone. Then whisper in their ear, "open your eyes" Remove tube and have them move themselves to the gurney. Works like a charm. (you do have to know your surgeons, and use your narcotics judiciously). You don't want any memory of emergence.
Qwiigley, BSN, MSN, DNP, RN, CRNA
571 Posts
Turn off the sevo while the surgeons are closing (you have to know how long your surgeons take to close) go to SIMV, turn on the N2O 1.5L and O2 at 1L. When you want to gas more Sevo off, turn volumes of N2O to 8 and O2 to 6.5. (It will blow off more Sevo). Then after the dressing is on, (your residual Sevo will be low, .2 or .1) then turn the N2O off. Wait for a few min. until nitrous is gone. Then whisper in their ear, "open your eyes" Remove tube and have them move themselves to the gurney. Works like a charm. (you do have to know your surgeons, and use your narcotics judiciously). You don't want any memory of emergence.