preoperative measures
Last reviewed 01/2018
Preoperative treatment in the patient with generalised peritonitis is as important as surgery:
- correct fluid balance due to lost extracellular fluid:
- give a rapid IV infusion of Hartmann's solution, 2.5-3.0 litres over 3 hours in a 70kg adult
- monitor central venous pressure in elderly patients to ensure that infusion is not given too quickly
- insert a urinary catheter to monitor urinary output
- give additional colloid if there is evidence of hypovolaemia
- remove blood for culture, then give parenteral antibacterial treatment, e.g. metronidazole for anaerobes and cephalexin for aerobes
- give analgesic, preferably IV slowly, after consulting with the anaesthetist
- give oxygen via a face mask as diaphragmatic movements are likely to be reduced
- before inducing anaesthesia, pass a 16F nasogastric tube to keep the stomach empty