I agree with jafo1964. We treat bone cement reaction with fluids (given prior to cementing), ephedrinum and - of course - oxygen.

Hello, there are no recommendations. I asked about the iv-size during my training in the blood-donor centre. I was told that it didn't really matter. Of course, it is impossible to give blood quickly with the 20-22G, but it is possible and acceptable if no other access is available. In my opinion, 18-16G is the best.

1 mg of Remi in Propofol? Are You sure about that dose? Anyway - is it ok to mix these drugs? We use Fentanyl and then - Remifentanyl, You are all right about the stiffness, but You need to give drugs slowly - whenever You push them with a high speed, You get troubles.

We use fluids and Ephedrinum - which is sometimes given with 500 ml of NaCl (first - the bolus, and then a bag). If the hypotension is lasting despite our treatment, we use Dopamine. Once, or twice - we have given additionally Hydrocostrisonum iv.

We often use a mixture of Metizol (Pyralgin) 5 g + Tramadol 0,5 g + Metoclopramid 10 mg, supplemented with Nacl 0,9% (up to the volume of 50 ml), as an iv infusion (with the speed 2-3 ml / h). The results are astonishing - a lot of our patients (after the nephrectomia, amputatio uteri) are unresponsive to pain, with the NRS 1-2/10 points. Of course, we use these drugs 30 min before the end of the operation, sometimes preceded with the 5 ml bolus. Do You use any other iv infusions, which are the combination of several, useful drugs? 

Have You ever used Ketamine for preemptive analgesia? Sometime ago I read an article about it - it was told to use Ketamine up to three times, with the overall dose of 0,45 mg/kg given iv. I have tried to do this once and the result was great. What are Your opinions?

Well, as I know, 2 ml of Lidocaine 1% given before injection is also sufficient.