<![CDATA[Ovarian cysts are among the most frequent ovarian lesions and can develop into massive tumors, potentially causing systemic manifestations. When significantly enlarged, these masses may exert upward pressure on the diaphragm, resulting in respiratory compromise, cardiovascular disturbances, and an increased risk of intraoperative hemodynamic instability posing considerable challenges for anesthetic management. This case report describes a 42-year-old woman with a history of hypertension and progressive abdominal distension over six months, accompanied by shortness of breath. She was diagnosed with a suspected malignant ovarian cyst. Clinical evaluation showed a 35×35 cm abdominal mass, mild anemia, thrombocytosis, hypoalbuminemia, and bilateral pleural effusion. The patient was categorized as ASA physical status III and underwent exploratory laparotomy under general anesthesia using orotracheal intubation and rapid sequence induction. Anesthesia was maintained with titrated propofol, intermittent fentanyl, and atracurium. Ventilation was managed with a low tidal volume strategy, and both static and dynamic hemodynamic parameters were monitored via arterial line and central venous catheter. Patients with large ovarian tumors are at increased risk of perioperative complications due to elevated intra-abdominal pressure and the potential for abrupt hemodynamic changes following tumor decompression. Choosing an appropriate anesthetic technique is essential, particularly in oncologic cases. Propofol-based total intravenous anesthesia (TIVA) is considered beneficial for its potential immunomodulatory and antitumor properties. Individualized anesthetic strategies are necessary to optimize respiratory stability, hemodynamic control, and long-term oncologic outcomes.]]>
Copyrights © 2026
