So about a week ago I'm put in a GYN room where the surgeon was placing an interstim for overactive bladder. The case is done prone, so I was setting up for GETA when the circulator tells me the surgeon likes it under "MAC."

Turns out what the surgeon wants is to call it a MAC, but for the patient to not move at all. Surgeon even tells me a couple of times, " I don't want her moving, but don't paralyze her." Clearly said surgeon has no freaking clue about anesthesia, as the patient is prone on a nasal cannula (uh, no, I don't think I'll paralyze her). The case happened to go without a hitch, but I'm well aware that doing an anesthetic this way has got to be considered very risky. Propofol gtt was at about 100 mcg/kg/min. I think I'll have no choice but to raise my concerns if I get put in this surgeon's room again for this type of case.

Does anyone else agree that it's crazy to do a case like this? Am I overreacting?