Have atropine or glycopyrrolate (Robinul) available. These drugs are to counteract bradycardia associated with the trendelenburg position and/or vagal stimulation commonly seen with uterine procedures. Like most abdominal procedures, heat loss can be significant through the open incision. Apply an upper body convection blanket as soon as possible. Trendelenburg position implies increased CVP and PIP. Increased chances of gastric regurgitation. Surgeon may inject epinephrine or vasopressin to decrease local bleeding (monitor for brady/tachydysrythmias). PONV common. Use a multimodal approach where possible. Postoperative Pain - bilateral mid-axillary TAP and/or Ilioinguinal-Iliohypogastric blocks are very effective for postoperative pain. PCA pumps are also sometimes utilized. Use adjuncts such as NSAIDS and/or acetaminophen where possible. Foley catheter - the procedure will likely be more than 2 hours Sometimes an enlarged uterus will obstruct ureters - so be aware of kidney function.
This is the removal of the uterus through an incision made in the abdomen.
