Aspects spécifiques de l'anesthésie en chirurgie abdominale par laparotomie de l'adulte

Improved knowledge of the physiology of the peritoneum and various intra-abdominal organs has resulted in an improved management of patients undergoing major abdominal surgery. The access of the abdominal cavity by laparotomy induces maladjustment within a very complex environment. This is related to the fact that drainage of the abdomen is carried out, accompanied primarily by respiratory repercussions, the most frequent cause of postoperative complications. An increasing number of older patients with high surgical risk benefit from major abdominal surgery. Their anaesthetic management begins together with the preoperative period during which nutritional management is sometimes necessary. The postoperative rehabilitation of the patients is very important, because it facilitates recovery, reduces the hospital stay duration and improves the post-surgical health-related quality of life. Postoperative rehabilitation includes better management of nauseas and vomiting, and the use of regional anaesthesia for postoperative analgesia.