Postop CarePostop problems are hypoxaemia, dehydration, pain, PONV, DVT, wound healing.

Continuous oxygen therapy with Venti-mask + humidification for 2 days while on opioid analgesics. Overnight on day 2,3,4

Dehydration due to insensible losses through sweating/respiration/faeces/urine, ongoing losses through haemorrhage/drain, third space losses through oedema.

Postop pain is bad, can cause distress, physiological disturbance, cardio and respi complications. Cardio= tachycardia and HTN lead to increased myocardial O2 demand and might end up with MI. Respi= patient breathes shallow leads to low tidal volume/low vital capacity results in basal atelectasis and pneumonia. Patients not moving due to pain lead to DVT and PE.

Vomiting centre in medulla is mediated by acetylcholine, histamine, dopamine and serotonin. If one antiemetic does work, swap with another group. Never use medication from same group. Anticholinergic = hyoscine. Antihistamines= cyclizine. Antidopamine = metoclopramide. Antiserotonin= ondansetron. Steroid might help PONV. For postop, use ondansetron or cyclizine. Add dexamethasone in severe case.

Risk of DVT increase postop because immobility and activation of coagulation cascade in response to tissue injury. High risk group has previous DVT/PE history, major surger for malignant disease, lower limb orthopaedia surgery.