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Preoperative measures

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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