I had the advantage of training in a bunch of different practices in several states and have seen a few ways to do the same thing. I am somewhat interested in being more on the high narcotic to balanced side of things.

one of my attendings said, "less than 5mcg/kg of fentanyl is homeopathic" and felt that if the case was an hour or longer the average person could handle 8-10 mls of fentanyl on induction and be very comfortable and breathing in an hour. I like how stable the vitals are and how smooth the wakeups are with frontloading narcotics.

How do you do it? is it a mcg/kg that changes based on length of surgery or something else? I am curious to hear from the high narcotic dosers