Last friday I was with a really interesting CRNA who only does PRN at the place I'm doing clinicals at. He had quite a few different techniques because he does independent practice, all of it quite different than what the regulars at the hospital use

On one MAC case we used a ketamine/propofol drip 1:5 ratio. The patient was a vietnam vet, 6 pack/day drinker, 1.5 pack/day smoker

we loaded him with , 10 of morphine, 4 of versed, and it didn't touch him

started the propofol/ketamine mix at 70-100mcg/kg/min (set for propofol) and the guy was OUT.

RR was good, needed a little support, but nothing severe. .2 robinul right before starting the drip.

At the end of the case, the drip was shut off and the guy woke up beautifully, almost on command

The only time I've seen it used was as a dart on an uncooperative MR patient.

so, anyone have any suggestions about using ketamine? I'm really intrigued by its potential

Drip it as a part of a combined general? post op pain? Sole anesthetic? I'm really curious what other people's experiences and tricks with it are.