Difference between revisions of "Appendectomy"

Appendectomy
Anesthesia type	General
Airway	Endotracheal tube
Lines and access	Peripheral IV
Monitors	Standard ASA 5-Lead EKG
	Primary anesthetic considerations
Preoperative	Full Stomach Precautions
Intraoperative	Rapid Sequence Induction
Postoperative	PONV
	Article information
Editor rating	Certified
Likes	2
	Top authors
	Barrett Larson, Chris Rishel and Test User 8

VisualWikitext

Revision as of 21:10, 3 February 2021

An appendectomy is generally performed as an urgent or emergent procedure to treat acute appendicitis. An appendectomy can be performed laparoscopically or as an open procedure. Surgical practice has largely transitioned to the laparoscopic approach.

Preoperative management

Preoperative evaluation


Respiratory	Acute abdominal pain can use respiratory impairment (respiratory splinting) resulting in atelectasis
Cardiovascular	May be dehydrated due to fever, emesis, and reduced oral intake Assess volume status by checking vital signs, mucus membranes, skin turgor. IV hydration before anesthetic induction
Gastrointestinal	Patients typically present with nausea and vomiting. Patients with acute abdomen should be treated as if they have full stomachs. Muscular resistance to palpation (muscle guarding) can correlate with severity of the inflammatory process.
Hematologic	Patients typically have moderate leukocytosis with left shift Expect hemoconcentration if patient dehydrated
Labs	CBC Chemistry Panel Pregnancy test (for women of child bearing age)

Labs

CBC
Chemistry panel
Pregnancy test (for women of child bearing age)

Operating room preparation

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Maintenance and surgical considerations

Emergence

Postoperative management

Disposition

Pain management

Potential complications

Procedure variants


	Open Appendectomy	Laparoscopic Appendectomy
Unique considerations
Position	Supine	Supine
Surgical time	1 hour	30-90 mins
EBL	<75 mL	<75 mL
Postoperative disposition	PACU	PACU
Mortality	Perforated: 2% Non-perforated: <0.1%	Perforated: 2% Non-perforated: <0.1%
Complications	Perforation Abscess Fistula Hematoma Illeus	Perforation Abscess Fistula Hematoma Illeus Conversion to Open
Pain	5-7	4

References

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 ===Preoperative evaluation<!-- Provide a brief overview of the preoperative evaluation and optimization of patients for this case. Also list relevant labs, studies, or physical exam findings. If none, this section may be removed. -->===
-'''History and Physical'''
 {| class="wikitable"
 |+
-!System
-!Considerations
 |-
 |Respiratory
@@ Line 39: / Line 36: @@
 |Hematologic
 |
+* Patients typically have moderate leukocytosis with left shift
+* Expect hemoconcentration if patient dehydrated
 |-
+|Labs
 |
-|
+* CBC
+* Chemistry Panel
+* Pregnancy test (for women of child bearing age)
 |}