We successfully managed
anesthesia in a patient with a giant ovarian
tumor weighting 22 kg, using FloTrac x Vigileo monitoring system. A 43-year-old woman (67.2 kg, 154.5 cm and abdominal girth 111.3 cm) was admitted for removal of a giant ovarian
tumor. Arterial blood pressure (ABP), heart rate, percutaneous arterial oxygen saturation, cardiac index (CI) and stroke volume variation (SVV) were monitored.
General anesthesia was induced, with the patient in the supine position, using 50 mg
propofol, 0.25 microgram x kg(-1) x min(-1)
remifentanil. 30 mg
rocuronium bromide and inhalation of 100%
oxygen, and maintained with
sevoflurane 1.5% and
remifentanil administration between 0.1-0.3 microgram x kg(-1) x min(-1). Following 6 l fluid drainage from the ovarian
tumor, ABP and CI decreased, but SVV remained within normal ranges. Therefore, we only decreased the drainage speed without increasing fluid administration rate. When the
tumor was lifted up, both CI and SVV increased, but the increase of SVV was 10%, still within normal ranges. Therefore, we did not increase fluid administration rate to avoid excessive hydration. After tracheal extubation, respiratory and hemodynamic states were stable, and the patient had no postoperative complication. We conclude that FloTrac x Vigileo System is useful for monitoring cardiac performance parameters, and helps anesthesiologists adjust drainage speed of the content and infusion rate to maintain the stability of circulatory state, in removal of a giant
cyst.