Abstract
A 70-year-old women with ovarian cancer, admitted to National Hakodate Hospital, complaining unconsciousness, nausea and lower abdominal fullness. Severe hyponatremia (104mEq/l) probably due to ascites was observed and corrected slowly with sodium supplementation and water restriction. After the recovery of neurologic symptoms, she received epidural anesthesia for open laparotomy. No remarkable neurologic and cardiovascular changes were found during the surgery. Appropriate sodium supplementation, fluid management and the choice of anesthetics are important for perioperative management of severe hyponatremic patient
