Anaesthetic Management of a Giant Retroperitoneal Tumor

Sarcomas are malignant tumors developing from mesenchymal cell lineages. The most common soft tissue sarcoma and prevalent retroperitoneal sarcoma is liposarcomas. As this was a major surgery, in view of anticipated blood loss, need for vasoactive medication, a central venous catheter was secured, epidural catheter was placed. Patient was induced as per the standard anaesthesia protocol and maintained on O2, N2O and Isoflurane. An arterial line was placed. A low dose Noradrenaline infusion was started. Intraoperatively 2 pints of PRBC was transfused, patient was shifted to ICU for elective ventilation. Regular epidural top ups were given for post operative analgesia. Patient was reposted for total thyroidectomy and neck dissection after 15 days and the main concerns of this surgery were the vascularity of tumour and post operative development of tracheomalacia. Utmost care was taken for fluid management and blood loss for the case and patient was checked for vocal cord movements to confirm the absence of recurrent laryngeal nerve injury and tracheomalacia. The anaesthetic management was handled successfully without any complications.