Our experience with anesthetic management of conjoined twins' separation surgery
Conjoined twins are one of the most fascinating human malformations. Here, we report the anesthetic management and challenges faced in performing the successful separation surgery of 4-day-old thoraco-omphalopagus conjoined twins, born at term to a multigravida by elective caesarean section weighing...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
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| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2020;volume=14;issue=1;spage=100;epage=103;aulast=Rawat |
| _version_ | 1828390097461968896 |
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| author | Amber Rawat Richa Rai Anil K Paswan Vaibhav Pandey |
| author_facet | Amber Rawat Richa Rai Anil K Paswan Vaibhav Pandey |
| author_sort | Amber Rawat |
| collection | DOAJ |
| description | Conjoined twins are one of the most fascinating human malformations. Here, we report the anesthetic management and challenges faced in performing the successful separation surgery of 4-day-old thoraco-omphalopagus conjoined twins, born at term to a multigravida by elective caesarean section weighing 3.5 kg with APGAR score of more than 7. Computerized tomography scan revealed fused anterior surface of the left lobe of liver with common left portal vein. Confirmation of cross-circulation between the twins was done by giving intravenous midazolam to one of the conjoined twins, but no effect seen in the other one. We highlighted the responsibility of anesthesia team in anesthetizing sequentially the two patients who are joined together, technical difficulty of intubating the twins facing each other, need of careful monitoring, anticipation of complications such as massive blood loss, hemodynamic instability, desaturation, and hypothermia, and preparedness for their management and vigilant postoperative care. |
| first_indexed | 2024-12-10T06:38:28Z |
| format | Article |
| id | doaj.art-1da0d0c76b864839a92c1333aa3238af |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-10T06:38:28Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-1da0d0c76b864839a92c1333aa3238af2022-12-22T01:58:51ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2020-01-0114110010310.4103/sja.SJA_142_19Our experience with anesthetic management of conjoined twins' separation surgeryAmber RawatRicha RaiAnil K PaswanVaibhav PandeyConjoined twins are one of the most fascinating human malformations. Here, we report the anesthetic management and challenges faced in performing the successful separation surgery of 4-day-old thoraco-omphalopagus conjoined twins, born at term to a multigravida by elective caesarean section weighing 3.5 kg with APGAR score of more than 7. Computerized tomography scan revealed fused anterior surface of the left lobe of liver with common left portal vein. Confirmation of cross-circulation between the twins was done by giving intravenous midazolam to one of the conjoined twins, but no effect seen in the other one. We highlighted the responsibility of anesthesia team in anesthetizing sequentially the two patients who are joined together, technical difficulty of intubating the twins facing each other, need of careful monitoring, anticipation of complications such as massive blood loss, hemodynamic instability, desaturation, and hypothermia, and preparedness for their management and vigilant postoperative care.http://www.saudija.org/article.asp?issn=1658-354X;year=2020;volume=14;issue=1;spage=100;epage=103;aulast=Rawatanesthetic management; conjoined twins; separation surgery; thoraco-omphalopagus |
| spellingShingle | Amber Rawat Richa Rai Anil K Paswan Vaibhav Pandey Our experience with anesthetic management of conjoined twins' separation surgery Saudi Journal of Anaesthesia anesthetic management; conjoined twins; separation surgery; thoraco-omphalopagus |
| title | Our experience with anesthetic management of conjoined twins' separation surgery |
| title_full | Our experience with anesthetic management of conjoined twins' separation surgery |
| title_fullStr | Our experience with anesthetic management of conjoined twins' separation surgery |
| title_full_unstemmed | Our experience with anesthetic management of conjoined twins' separation surgery |
| title_short | Our experience with anesthetic management of conjoined twins' separation surgery |
| title_sort | our experience with anesthetic management of conjoined twins separation surgery |
| topic | anesthetic management; conjoined twins; separation surgery; thoraco-omphalopagus |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2020;volume=14;issue=1;spage=100;epage=103;aulast=Rawat |
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