Background: Gabapentin is used as an anti-epileptic and in chronic pain but can be used also in acute postoperative pain by giving it preoperatively in a single or in two divided doses combined with intrathecal morphine. Objectives: This study aimed to detect the role and value of gabapentin as analgesic in postoperative analgesia. Presentation of the case: A case with orthopedic surgery that had no postoperative pain for 24 hours and needed no analgesia with good (near normal) mobility after taking preoperative gabapentin and intrathecal morphine with spinal anesthesia intraoperative. Results: It is a rare condition in which the patient is pain-free completely for 24 hours without any postoperative analgesia, most researchers stated that patients who received preoperative gabapentin need less postoperative analgesia or morphine but still there is pain. Conclusion: Preoperative gabapentin has a great effect on postoperative pain, decreasing analgesic doses especially morphine with good and early postoperative mobility.

Background:severe preeclampsia (PET) is one of the hypertensive diseases of pregnancy associated with significant morbidity and mortality and require special monitoring, lung ultrasonography is a novel monitoring and diagnostic tools in intensive care and widely used nowadays with early detection of pulmonary oedema. Patients and Methods:this was a cross sectional study of 55 patients with severe preeclampsia,35 case with eclampsia and 60 healthy controls. Lung ultrasonography was done to detect B lines in 12 lung zone postoperatively in both cases and controls fluid input and output is encounted. Results:Median (Min-Max) of lung sonar was higher in severe PET than in controls p value = .0001. B lines were observed in 47.2% and 8.3% in eclampsia ,severe PET and controls respectively. There was highly statistically significant difference between cases and controls as regards input and output as (P=.005), (P=.003) respectively as input and output was higher in control group than cases group) While there was no statistical significance difference between cases and controls as regards net balance as (P=.09). complications occur in higher percentage in cases than control. Conclusions: Restrictedfluid policy is indicated with the finding of B pattern especially with higher lung ultrasound score. Early management in patients with high B line score (pulmonary congestion) even before development of clinical manifestations should be considered.

Background: Severe preeclampsia (PE) and eclampsia are a hypertensive disease of pregnancy associated with significant morbidity and mortality and require special monitoring. Lung ultrasonography and transthoracic echocardiography are a novel monitoring and diagnostic tools in intensive care and are widely used nowadays. Objective: To detect the role and value of transthoracic echocardiography (TTE) in postoperative monitoring in patients with severe PE. Patients and Methods: This was a cross sectional study of 55 patients with severe preeclampsia, 35 patients with eclampsia and 60 healthy controls. Transthoracic echocardiography was done to evaluate diastolic function using E/A ratio with continuous wave Doppler, ejection fraction using M mode in long axis parasternal view and inferior vena cava (IVC) diameter in subcostal view. All measurements were done postoperatively. Results: There was significant difference between the 3 groups regarding diastolic function (p value 0.0001). Abnormal diastolic function in severe PE, eclampsia and controls was 81.2%, 94.3% and 5% respectively. There was no difference between the 3 groups of the study as regard IVC diameter. There was significant difference between the 3 groups as regards EF (P=0.007), the mean of EF in severe PE, eclampsia and controls was 66. 89 ± 5.54, 63.029 ± 8.45 and 66.43 ± 4.16 respectively. Conclusions: The use of transthoracic echocardiography is mandatory in postoperative monitoring in patients with severe PE and eclampsia as they can adjust management and detect complications. Restricted fluid therapy policy is indicated with the higher grades of diastolic dysfunction and lower ejection fraction (EF).