Role of Laryngeal Spasm in Negative Pressure Pulmonary Oedema.

Negative-pressure pulmonary edema (NPPE) is a clinical entity of anaesthesiologic relevance, peri-operatively caused by obstruction of the conductive airways (upper airway obstruction, UAO) due to laryngospasm in approx. 50% of the cases, its early recognition and treatment by the anaesthesiologist is mandatory. Laryngospasm, a brief closure of the vocal cords is not an uncommon peri-operative occurrence. If recognized and managed appropriately, the effects are transient and reversible. However, in rare cases where recognition and management are delayed, the consequences are associated with a high morbidity including desaturation, awareness, negative pressure pulmonary edema, and mortality.

Anaesthetic Management of Patients with Dilated Cardiomyopathy Undergoing Non-Cardiac Surgery.

The anaesthetic management of a patient with dilated cardiomyopathy (DCM) undergoing non-cardiac surgery has always posed a challenge for Anaesthesiologist either due to pre-existing or a risk of precipitating congestive heart failure. Hereby, we report a case of an elderly patient with Dilated cardiomyopathy and Ejection Fraction less that 35%, MET criteria more than 5 for mid- Ureteric calculus removal surgery under Epidural Anaesthesia.