What is included in preoperative care for intestinal perforation?

Updated: Jul 24, 2020
  • Author: Samy A Azer, MD, PhD, MPH; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

Preoperatively, correct any fluid or electrolyte imbalance. Replace extracellular fluid losses by administering Hartmann solution or a similar solution that has an electrolyte composition similar to plasma. Central venous pressure (CVP) monitoring is essential in critically ill and/or elderly patients, in whom cardiac impairment may be exacerbated by large fluid loss.

Administer systemic antibiotics (eg, ampicillin, gentamicin, or metronidazole), making a best estimation regarding the likely organisms. Nasogastric suction is required to empty the stomach and reduce the risk of further vomiting. Urinary catheterization is used to assess urinary flow and fluid replacement. Administer analgesics, such as morphine, in small IV doses, preferably as a continuous infusion.


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