Anaesthetic Management of a Patient With a Giant Ovarian Tumour Containing 28 Litres of Ascitic Fluid

We report the anaesthetic management of a 47-year-old woman scheduled for tumour resection of a giant ovarian tumour containing 28 litres of ascitic fluid. Her preoperative abdominal circumference was 186 cm due to massive ascites, and metabolic equivalents (METs) were less than 3.5. She was planned for cytoreductive surgery under general anaesthesia combined with epidural analgesia. Anaesthetic challenges included ventilatory management to maintain airway pressures, haemodynamic stability during massive fluid shifts, extensive monitoring, pre-induction epidural catheter placement, prevention of hypothermia, correction of metabolic or electrolyte derangements, and adequate postoperative pain relief.