OK folks, heres another useless topic I'm going to propose. We have an old, ricketty orthopedic surgeon who insists we put all his total knees to sleep for whatever reason, even though we use regional with every other surgeon unless contraindicated. And he's one of those control freak- whiners who is constantly complaining- particularly about lack of muscle relaxation. He swears that once the tourniquet is up, our muscle relaxants don't do any good. Now as I see it, doesn't the non-depolarizer still work at the muscles origin ABOVE the tourniquet which would facilitate muscle relaxation? This guy is crazy, folks, and lord knows why he complains about muscle relaxation when every other ortho dude I've worked with hasn't. "HOW MANY TWITCHES DO YOU HAVE???", he'll ask the CRNA. blah blah blah. Was it my mom that told me a little knowledge is dangerous?

Is there any basis to his complaint? Or can I end this for good, drag him out into the parking lot and settle this gangster style? haha

Anyway, point me in the direction of a paper that'll refute this old dude and I'll buy you dinner in New Orleans.

Anybody see patients cough after pushing generic propofol? Seems like I see it about 10% of the time. Maybe its the sulfites or something.?

Can anyone tell me if the degree of sympathectomy is commensurate with local anesthetic strength? For example, does .5% bupivicaine cause more of a sympathectomy than .25% bupivicaine?

Thanks