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  • Cited by 1
  • Print publication year: 2006
  • Online publication date: September 2009

19 - Anaesthesia for major abdominal and urological surgery

    • By Paul Myles, Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Australia, Kate Leslie, Department of Anaesthesia and Pain Management, Royal Melbourne Hospital and Department of Pharmacology, University of Melbourne, Melbourne, Australia
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Publisher: Cambridge University Press
  • DOI: https://doi.org/10.1017/CBO9780511544613.020
  • pp 223-246

Summary

This chapter describes many evidence-based interventions relevant to anaesthesia for abdominal surgery. The two most common analgesic therapies after abdominal surgery are patient controlled analgesia (PCA) and epidural analgesia. It has been suggested that a strategy of targeting tissue oxygen delivery, so-called "optimisation" or "goal-directed" therapy, can improve postoperative outcome. Patients undergoing major abdominal surgery are particularly at risk of hypothermia, because of the potential for significant heat loss. There is substantial evidence in the literature that maintenance of normothermia during major abdominal surgery may lead to improved outcomes. Major abdominal surgery patients, in particular cancer patients, are at relatively high risk of deep venous thrombosis (DVT) and pulmonary embolism. There is a large amount of evidence derived from randomised trials and meta-analyses of trials in abdominal surgical practice to guide anaesthetic practice.