Anaesthesia and bowel surgery

Many factors influence the outcome after surgery of the bowel. However, care in anaesthetic and postoperative management may help to reduce the frequency of complications. Such care can be directed at maintenance of or improvement in oxygen delivery to the bowel by the avoidance of hypoxia, hypocapnia and hypovolaemia, and by careful selection of drugs and techniques used during anaesthesia. Tension on anastomoses can be reduced by care in the administration of neostigmine, and possibly by the use of pethidine rather than morphine for analgesia during and after operation. Postoperative ileus may be affected by sedative and analgesic therapy.