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: Covid19 infection became one of the most widespread respiratory tract infections worldwide. The pandemic lastly spreading in Egypt made a great challenge for the health workers of different specialties. Anesthetists had to solve difficult problems related to the infected patients requiring surgical interventions and to make the balance between patient safety and medical team protection during the procedure. Objective: This study aimed to check for clear guideline protocol for anesthetic management of Covid-19 cases undergoing cesarean section, here is a case presentation for a twins pregnant patient. Case presentation: Female patient 32 years old diagnosed as covid-19 positive prepared for cesarean section for delivery of preterm twins with CT finding corads 5, clinically presented by acute respiratory distress syndrome (ARDS). The patient received spinal anesthesia associated with tap block, oxygenation was done by closed circuit system of the anesthesia machine with partial closure of adjustable pressure limiting (APL) valve and hypotension was managed by noradrenaline infusion during the procedure. Conclusion: Combined spinal anesthesia with tap block was the most successful modality for anesthesia for cesarean section (CS) in severe cases of covid-19 infected patients.