An SRNA friend of mine has been working a lot with a very experienced CRNA. The CRNA does lots of big ortho cases (spines with chronic patient, etc).

My buddy was telling me that the CRNA frequently manages his cases with very high dose narcotics, which is not surprising. However my friend told me that it was not uncommon for this CRNA to use titrate in narcan at the end of the cases during emergence (based on respiratory rate). The CRNA would take a 0.4mg vial of narcan and dilute in out in a 20cc syringe and give 1 cc at time. This was something he did quite a bit to the point my friend felt that it was part of his plan. I.e. with these patients, for these surgeries, when in doubt bury the patient with narcs and then work in narcan.

Has anyone ever heard of anything like this? (and yes, I know the 1/2 life of narcan)