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General Surgery

Laparoscopic Appendicectomy

Est. Duration: 2 hours

Summary

Last Updated: February 2025

General Anaesthesia

Airway:

Technique:

Last Updated: February 2025

Notes

Pneumoperitoneum -> bradycardia
CO2 insufflation -> hypercapnia

Induction

RSI / Modified RSI
Propofol ( 200mg )
Fentanyl ( 150mcg )
Rocuronium ( 1.2mg/kg )
Airway
ETT

Intra-Op

Maintenance

Sevoflurane ( MAC 1.2 )

Analgesia

Fentanyl ( 50mcg bolus, Titrate to effect ) or Morphine ( 0.1mg/kg )
Paracetamol ( 1g )
Magnesium ( 2.5g )

Anti-emetics

Ondansetron ( 4mg )
Dexamethasone ( 6.6mg )

Other

Antibiotics as required
Local anaesthetic infiltration by surgical team

Emergence

Procedure NMB Assessment
Sugammadex ( 2 or 4 mg/kg )
Awake extubation

Post-Op

Fentanyl ( Recovery Use Only )
Paracetamol ( 1g )
Ibuprofen ( 400mg )
Dihydrocodeine ( 30mg, PRN )
Ondansetron ( 4mg )