Abstract

Serious complications following surgery of the colon are usually associated with anastomotic breakdown. While many factors influence the outcome of such anastomoses, care in anesthetic and postoperative management may help to reduce the incidence of this occurrence. Such care can be directed at maintenance of or improvement in oxygen delivery to the anastomotic site by avoidance of hypoxia, hypocapnia, and hypovolemia, and possibly by the use of spinal nerve block. Tension on the anastomosis can be reduced by care in the administration of neostigmine, and possibly by the use of meperidine rather than morphine for intraoperative and postoperative analgesia.