Abstract
A 33-year-old woman with a giant ovarian cyst was admitted for surgical removal. She could sleep on either side of the lateral decubitis position, but not in the supine position. Chest radiography noted elevated diaphragm and deformity of the rib cage. Preoperative paracentesis while monitoring systemic and pulmonary artery pressures was scheduled. A total of 35 liters of mucinous fluid was removed over 35 hours without any hemodynamic disturbance. On the following day, anesthesia was induced in the supine position. Immediately after aspiration of remaining fluid, abrupt hypotension (80/50mmHg) with decreases of CVP and Pao2 was observed. These were restored gradually by intravenous vasopressor agents, crystalloid solution and increased FIO2. The weight of the tumor including preoperative fluid was approximately 53 kilograms. The patient recovered uneventfully and was discharged on postoperative day 30.
