Management of Gilbert's syndrome with low-dose, diluted hyperbaricity of spinal bupivacaine: A rare-rare combo

Gilbert's syndrome (GS) is an inherited unconjugated hyperbilirubinemia state. Regional anesthesia is recommended over general anesthesia in the management of these patients for surgeries. We describe anesthesia management of a young patient with GS for a below umbilical surgery, with modified spinal anesthesia by diluting the hyperbaricity and reducing the concentration in prone position. Selective sensory blockade with stable hemodynamics, faster recovery, and minimal stress response proved to be beneficial. When feasible, this modified spinal anesthesia can be opted for the management of short duration surgeries in patients with GS.