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This collection of recipes is intended for educational purposes only. Users should adapt these recipes based on individual patient requirements, clinical judgment, and adherence to local and national guidelines.

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Gas Cookbook | Laparotomy (Small Bowel Obstruction)

Laparotomy (Small Bowel Obstruction)

Pre-op Block Induction Intra-op Post-op

General Surgery

Laparotomy (Small Bowel Obstruction)

General AnaesthesiaDuration2 - 3 hoursUpdatedJun 2026ByGas Cookbook

Pre-op Block Induction Intra-op Post-op

Calculate NELA Score +/- ACS NSQIP Risk
Confirm clotting + valid G&S
Consider pre-oxygenation strategy (e.g. anticipated difficult airway / high BMI)

NeuraxialCSE

Spinal: 0.5% bupivacaine + 8% glucose2.2ml + morphine0.2mg

Check for contraindications of neuraxial block

Pre-Induction

ProcedureArterial Line
ProcedureRyles Tube + Suction
Consider cricoid pressure

Drugs (RSI)

fentanyl150mcg
propofol2.5mg/kg
rocuronium1.2mg/kg
metaraminolAs required

Other

AirwayETT

Post-Induction

Procedure

Maintenance

propofolTCI
remifentanilTCI

Infusions

metaraminol0.5mg/ml

Analgesia

morphine0.1mg/kg
magnesium sulphate5g
clonidine15mcg/ml, 0.5-1mcg/kg
paracetamol1g

Analgesia (if NBM)

morphinePCA
Paracetamol1g
Local anaesthetic infusion via epidural / rectus sheath catheters (if appropriate)

Anti-emetics

ondansetron4mg
cyclizine50mg

For reference only. Always check doses against the BNF and your local protocols, and adapt to the patient in front of you. Gas Cookbook is community-shared guidance, not medical advice; clinical responsibility stays with you.

Block

Procedure

Arterial Line Central Venous Catheter Line Epidural NG Tube Spinal

Technique

IV Induction RSI TIVA

Central Venous Catheter Line

diclofenac

75mg

Local anaesthetic infiltration by surgical team

Anti-emetics

ondansetron4mg
dexamethasone6.6mg

Other

Antibiotics as required