Journal of the Indian Medical Association
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Peripartum cardiomyopathy is an unusual form of dilated cardiomyopathy, which manifests as acute heart failure in the last trimester of pregnancy or early postpartum period. Its aetiology is currently unknown. The presenting signs and symptoms are those of congestive heart failure and more specifically those of left ventricular failure. ⋯ The goals of anaesthetic management include avoidance of drug induced myocardial depression and prevention of increases in ventricular preload and afterload. Vigilant monitoring is essential throughout the surgery and in the postoperative period and the need for invasive monitoring should be assessed according to the clinical condition of the patient. It is important to recognise the association of cardiac failure and pregnancy as a separate syndrome so that peripartum cardiomyopathy can also be kept as a differential diagnosis for cardiac failure occurring in the peripartum period and a high index of suspicion should be maintained for the timely detection and management of this condition.
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Randomized Controlled Trial
Analgesic effect of low gynaecological surgery under general anaesthesia.
Gabapentin has been used in the treatment of neuropathic pain as well as postoperative pain with good result. This study was done to investigate the effect of gabapentin in day-case gynaecological surgery under general anaesthesia. A randomised, placebo controlled, double blind study was undertaken on 200 patients of ASA I and II, aged 20 and 50 years, body weight of 50 +/- 0.06 kg undergoing day case gynaecological surgery under general anaesthesia. ⋯ Group-A patients showed lower VAS scores than the patients in group-B at 1st, 3rd and 6th hours postoperatively (p < 0.05). Moreover the total amount of rescue analgesic required in the immediate postoperative period observed for six hours was much higher in the group-B patients than in the patients in group-A (p <0.05). To conclude, the study showed that gabapentin used in low dose has got analgesic efficacy in the patients following day-case gynaecological surgery under general anaesthesia and has also significantly reduced the total requirement of rescue analgesic in the immediate postoperative period.
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Comment Letter Case Reports
Anaesthetic management of an epileptic pregnant women for trauma surgery--a case report.