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Hi every one,we do spinal anesthesia for c/s with 10-12mg hyper bar bupivacain in all of height &weight!
Yes,dose modification in relation with height& weight, not recommended. Although increasing the dose of spinal anesthetic increases block height, doses above 15 mg significantly increase the risk of complications and not recommended.
About drug concentration: blockade extent does not greatly affected by concentration,but the density of sensory block may be better with the 0.75% than the 0.5%.
Miller, page:2324
But we use 0.5%  probably because this form of drug  is available easily. ;)

Hello everyone.i,m iranian anesthesilogist.in our hospital we perform pron position spinal a. for all of pilonidal cyct surgeries.

In this technique at first,we  position the patient in prone position then use 1µg/kg fentanyl+1-2mg midazolam as premed.Then we use often paramedian approach for needle insertion.i use ketamin in analgesic dose after midazolam premed. In some of cases.
I don,t use pron position SA. For disk herniation surgery.plz tell us more about this technique.

thanks for ur ideas.but i dont  underestand mechanism of neurotoxicity of ketamin.if u have any references for it,plz explain for us.

Hi,dear Ourdream!
succinylcholin defiency,have not any late complication,and i agree with comments of gasman.

thanks 4 ur notes and ideas,yes i agree with u.But in our hospital a surgeon himself want this method and encourage it for some patient that afraid of G. anesthesia,and i agree with u,and for this reason i wrote all dissadvantages and emphasized that i dont offer to you.
I want only understand that in other centers anyone do it ?
and thank again for u.

Hi every one, in our hospital Rhinoplasty cases anesthetized with general anesthesia &intubation & awake ext. anesthesia always done with pofol inf. And midazolam+ fentanyl premedication. Recently, I use another method in some cases:
I give 1mg midazolam +Remifentanil infusion; start with 0.1mg/kg/min,and titrate until patient sedation, and in 5-10 min, allow surgeon to check the patient and start the surgery.During surgery we ask the patient to swallow secretions, and when needed surgeon suction the nasopharynx.
We use supportive oxygen via a nelaton sond that lye between patient teeth and we establish additional holes on it's surface.
This method need to good surgeon and good patient.
Complications and worries:
Hypoxemia closed monitoring and oxygen supplying is mandatory.
Aspiration: probable, but blood aspiration is benign in nature.
I'm not advising you to perform this method,
But if you have any experience about it, please explain our.
I emphasize: in this method we need doses of Remifentanil that higher than safe dose for spontaneous breathing, and may be isn't  a safe method!   

 ;)I use ketamin in our hospital in many of surgeries in two method:I use atropin 0.5mg+midazolam 1mg+75-125mg nesdonal ,then support patient breaths for transient apnea,then i use anesthetic dose of ketamin in divided doses, every 1-2 min.
In second method i use ketofol ;):
1:1 ketamin and propofol in one syringe.yes,it is very interesting method for our surgeries.
I use this methods for varicocele,pilonidal cysts(in pron position),and other simple surgeries.
In tubal ligations that is common in our center,i use spinal anesthesia or one of above methods,plus suxamethonium before that surgeon enter the peritoneal cavity.
now:i don't use anesthetic gas,dint use LMA, dint intubate patient,have minimal side effect as emergence reaction.
I definitely consider contraindications of ketamin in my cases.

Hi every body.we use halothane in our hospital routinly.because the insurance services only accept halathane >:(