For the fit and well patient
Pre-op
- Paracetamol
Intra-op
- Propofol – Marsh TCI
- Remifentanil – Minto TCI
- Remi on first building up to 6ng/ml, wait two minutes, then propofol 6mcg/ml
- Atracurium
- 16G cannula
- COETT
- Depth of anaesthesia monitoring
- 350mcg fentanyl throughout case
Post-op
- Fentanyl 0-200mcg in recovery
- Regular paracetamol
- Regular ibuprofen
- Tramadol or codeine
Alternatives
- Alfentanil works very well here, replacing both the remifentanil and fentanyl. Either use a TCI aiming for 100ng/ml, or a bolus of 1.5-3mg followed by an infusion of 4-6 ml/hr of neat (500 mcg/ml) alfentanil. They often don’t need any supplementary analgesia in recovery.
Anaesthetic Recipes 