Position: Supine, arms extended
Time: 1-2 hours (average)
Blood Loss: Moderate (50 – 200 ml)
Post-op Pain: High (7-10)
Maintenance Paralytic: Yes

Hydration – As an open belly case, you’ll need to make sure you hydrate.

Avoid Nitrous – Avoid Nitrous Oxide, as it can lead to distended intestines/excessive pressure at the surgical site.

Pain – Large incision. Pain levels will be high. Sometimes the surgeon will request an epidural placed either before or after the surgery. Communicate with the surgeon well before the case.

High post-operative pain (general considerations): Plan ahead to treat pain in the postoperative period. If not contraindicated, consider hydromorphone or other long-acting analgesics along with adjuncts such as Ofirmev and/or toradol. Where possible, give during the operative period to limit pain in the postoperative period. Where applicable, consider peripheral nerve blocks and/or epidural interventions.