PURPOSE: An unusual case of @entity42 was successfully anaesthetized with a combination of epidural followed by general anaesthesia. The method was chosen to avoid @entity308 and re-expansion @entity4 in @entity5 in a @entity1 who did not understand the nature of @entity3250 . CLINICAL FEATURES: A 58-yr-old @entity1 (107.6 kg, 150 cm and abdominal girth: 163.5 cm) was admitted for removal of @entity42 . There was gross-pitting @entity4 of both legs and an elevated diaphragm but no @entity1143 . She did not understand the severity of @entity3250 . It was decided to drain the cyst gradually, followed by total surgical removal on the same day. An epidural catheter was inserted at the @entity6357 interspace with the @entity1 in the left lateral position and, under epidural anaesthesia, 44.3 L fluid were drained over two hours without producing @entity308 or @entity4 . General anaesthesia was induced, with the @entity1 in the supine position, by slow injection of 10 mg @entity1363 , 100 micrograms @entity3575 and inhalation of @entity3810 50% in @entity26 , and maintained with adding epidural block using @entity3303 1.5% and @entity1341 0.5%, and @entity2614 0.4 to 0.8%. During surgery, the volume of infused fluid was carefully controlled with central venous pressure monitoring. Ulinastatin, a protease inhibitor, was infused to prevent @entity4 . No @entity308 nor @entity4 occurred perioperatively. CONCLUSION: For the removal of @entity42 , slow drainage over two hours under epidural anaesthesia may safely precede later removal of the cyst on the same day under general anaesthesia.

Same day drainage and removal of XXXX .

@entity1 :: ('9606', 'Species') :: ['woman', 'patient'] @entity1143 :: ('MESH:D010996', 'Disease') :: ['pleural effusion'] @entity308 :: ('MESH:D003866', 'Disease') :: ['circulatory depression'] @entity5 :: ('MESH:D009369', 'Disease') :: ['removal of a giant tumour'] @entity4 :: ('MESH:D004487', 'Disease') :: ['oedema', 'pulmonary oedema'] @entity3250 :: ('MESH:D006013', 'Disease') :: ['her disease'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity42 :: ('MESH:D010048', 'Disease') :: ['a giant ovarian cyst'] @entity3575 :: ('MESH:D005283', 'Chemical') :: ['fentanyl'] @entity3303 :: ('MESH:D008012', 'Chemical') :: ['lidocaine'] @entity1341 :: ('MESH:D002045', 'Chemical') :: ['bupivacaine'] @entity3810 :: ('MESH:D009609', 'Chemical') :: ['nitrous oxide'] @entity2614 :: ('MESH:C009250', 'Chemical') :: ['sevoflurane'] @entity6357 :: ('6164', 'Gene') :: ['L3-4'] @entity1363 :: ('MESH:D008874', 'Chemical') :: ['midazolam']
@entity42 :: (MESH:D010048,Disease) :: ['a giant ovarian cyst']
