A short procedure, often part of a high turnover day case list
Pre-op
- Paracetamol
- Ibuprofen
Intra-op
- 20G cannula
- Propofol TCI Marsh model
- 1mg Alfentanil in each 50ml of propofol (20mcg/ml)
- 6.6mg dexamethasone
- LMA
Post-op
- PRN paracetamol
- PRN ibuprofen

Thought propofol/opioid admixtures were not recommended due to separation of the drugs?
Per immiscibility of prop emulsion & iv solution and hence unpredictable adminstration of the opioid.
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I would consider remifentanil and alfentanil separately.
Remifentanil layers out in a syringe of propofol, and becomes unstable at low concentrations. The Association of Anaesthetists Guidelines for the safe practice of total intravenous anaesthesia (TIVA). It is however commonly used in paediatrics without issue.
Alfentanil mixed into propofol is a common technique and works well. Indeed, it is mentioned in the Summary of Product Characteristics (SmPC).
Hope that helps!
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