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.