Article,
Anesthetic management of a patient with a giant ovarian tumor complicated with cerebral palsy
Masui, 39 (9): 1234--1238 (September 1990)
Abstract
The anesthetic management of a patient with a giant ovarian tumor (16.5kg) was reported. The patient was a 32 year old female with cerebral palsy and severe mental retardation. The management of anesthesia in this case including induction of anesthesia, intra-operative hypotension due to removal of tumor and post operative pulmonary complication, should be considered carefully. Especially, the monitoring of central venous pressure was essential, because the venous return fluctuates markedly depending on the surgical procedure. Patient had no premedication. Anesthesia was induced with halothane, nitrous oxide and oxygen by mask with the monitoring of ECG, and radial arterial as well as central venous pressure. Following easy tracheal intubation, bronchospasm occurred, which induced multifocal PVC's. This PVC turned to bigeminy and treatment with such drug as lidocaine was not effective. Anesthesia was maintained with enflurane, nitrous oxide and oxygen. Bigeminy disappeared 5 minutes after discontinuing enflurane anesthesia. Post-operative course was uneventful. The merit of slow induction method with halothane, nitrous oxide and oxygen has not been proved in this special case.
