The pulse after celiotomy usually remains below 100. It often, however, reaches 115 or 120, and sometimes higher, in patients who have a favorable convalescence. A rapid pulse unaccompanied by unfavorable abdominal symptoms often indicates some heart-trouble.
A pulse of over 120 accompanied by abdominal distention and vomiting should always excite alarm.
Strychnine and digitalis, administered hypodermically, are the most useful medicines for strengthening the heart and diminishing the rapidity of the pulse. They should be given in large doses—1/20 of a grain of strychnine every three or four hours, and 10 minims of tincture of digitalis at similar intervals.
Hypodermic injections of strychnine are most useful for shock after celiotomy. This drug may be exhibited until the physiological action—twitching or jerking of the muscles—is observed. The writer has administered between 1 and 2 grains during the first twenty-four hours after celiotomy, with recovery.
The temperature after celiotomy runs no regular course. It usually remains below 102° F. A greater elevation of temperature than this may occur during a favorable convalescence; and; on the other hand, a fatal termination may take place when the temperature remains lower. The maximum temperature is usually observed about the second or third day.
The temperature often rises on account of very trivial causes. It may go up one or two degrees if the patient should become constipated, and will drop as soon as a free fecal movement has taken place.
Fig. 207.—Composite temperature-chart of a series of 150 successful cases of celiotomy: average temperatures, pulses, and respirations for two weeks after operation.
The comfort of the patient is much increased by sponging the arms and legs with tepid water. The nurse should be instructed to sponge the patient in this way whenever the temperature reaches 102° F.
The patient should maintain the recumbent posture for three weeks after celiotomy. She may then sit up in bed for two or three days, and if then sufficiently strong, she may leave the bed.