Anesthetic management of a severely obese patient (body mass index 70.1 kg/m2) undergoing giant ovarian tumor resection: a case report

被引:2
作者
Yamochi, Shoko [1 ]
Kinoshita, Mao [1 ]
Sawa, Teiji [1 ]
机构
[1] Kyoto Prefectural Univ Med, Dept Anesthesiol, Kyoto 6028566, Japan
关键词
Severe obesity; Giant ovarian tumor; Nasal high flow cannula; Reexpansion pulmonary edema; PRE-OXYGENATION; PREOXYGENATION; POSITION; VENTILATION; PRESSURE; TRIAL;
D O I
10.1186/s13256-022-03383-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Giant ovarian tumors are rarely seen with severe obesity. There are few reports of perioperative management of giant ovarian tumors and severe obesity. Here, we report the perioperative management of physiological changes in massive intraabdominal tumors in a patient with severe obesity. Case presentation A 46-year-old Japanese woman (height 166 cm, weight 193.2 kg; body mass index 70.1 kg/m(2)) was scheduled to undergo laparotomy for a giant ovarian tumor. The patient was placed in the ramp position. Preoxygenation was performed using a high-flow nasal cannula, and awake tracheal intubation was performed using a video laryngoscope. Mechanical ventilation using a limited tidal volume with moderate positive end-expiratory pressure was applied during the surgical procedure. The aspiration speed for 15 L of tumor aspirate was set to under 1 L/minute, and the possibility of reexpansion pulmonary edema was foreseen by conventional monitoring. Conclusions We successfully completed anesthetic management in a patient with concomitant severe obesity and giant ovarian tumors.
引用
收藏
页数:4
相关论文
共 20 条
[1]   Management of a Giant Ovarian Tumor More Than 30kg: A Case Report and Review of the Literature [J].
Akazawa, Munetoshi ;
Saito, Toshiaki ;
Nagayama, Rina ;
Ariyoshi, Kazuya ;
Okadome, Masao .
JOURNAL OF GYNECOLOGIC SURGERY, 2018, 34 (05) :243-247
[2]   Pre-oxygenation in the obese patient:: effects of position on tolerance to apnoea [J].
Altermatt, FR ;
Muñoz, HR ;
Delfino, AE ;
Cortínez, LI .
BRITISH JOURNAL OF ANAESTHESIA, 2005, 95 (05) :706-709
[3]   Supplementation of pre-oxygenation in morbidly obese patients using nasopharyngeal oxygen insufflation [J].
Baraka, A. S. ;
Taha, S. K. ;
Siddik-Sayyid, S. M. ;
Kanazi, G. E. ;
El-Khatib, M. F. ;
Dagher, C. M. ;
Chehade, J.-M. A. ;
Abdallah, F. W. ;
Hajj, R. E. .
ANAESTHESIA, 2007, 62 (08) :769-773
[4]   EFFECTIVENESS OF PREOXYGENATION IN MORBIDLY OBESE PATIENTS [J].
BERTHOUD, MC ;
PEACOCK, JE ;
REILLY, CS .
BRITISH JOURNAL OF ANAESTHESIA, 1991, 67 (04) :464-466
[5]   The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta-analysis of randomised control trials [J].
Clark, K. ;
Lam, L. T. ;
Gibson, S. ;
Currow, D. .
ANAESTHESIA, 2009, 64 (06) :652-657
[6]  
Couture EJ, 2018, CAN J ANESTH, V65, P522, DOI 10.1007/s12630-018-1050-1
[7]   How to ventilate obese patients in the ICU [J].
De Jong, Audrey ;
Wrigge, Hermann ;
Hedenstierna, Goran ;
Gattinoni, Luciano ;
Chiumello, Davide ;
Frat, Jean-Pierre ;
Ball, Lorenzo ;
Schetz, Miet ;
Pickkers, Peter ;
Jaber, Samir .
INTENSIVE CARE MEDICINE, 2020, 46 (12) :2423-2435
[8]   Preoxygenation is more effective in the 25° head-up position than in the supine position in severely obese patients -: A randomized controlled study [J].
Dixon, BJ ;
Dixon, JB ;
Carden, JR ;
Burn, AJ ;
Schachter, LM ;
Playfair, JM ;
Laurie, CP ;
O'Brien, PE .
ANESTHESIOLOGY, 2005, 102 (06) :1110-1115
[9]   Giant ovarian cysts: Is a pre- and intraoperative drainage an advisable procedure? [J].
Einenkel, J. ;
Alexander, H. ;
Schotte, D. ;
Stumpp, P. ;
Horn, L. -C. .
INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 2006, 16 (06) :2039-2043
[10]  
Ikeda Tsubasa, 2014, Masui, V63, P439