Martínez MJF, Duran JEN, Álvarez DA, Martínez BY

Language: Spanish
References: 7
Page: 70-77
PDF size: 106.30 Kb.

ABSTRACT

Introduction: the conjoined twins' separation provokes great interest due to the complexity of anesthesia and surgery, the rarity of the disease and associated mortality.
Objective: present anesthetic management in the separation of conjoined twins at Maria Eugenia Neto Hospital, Northern Province in Angola.
Method: after adequate preoperative assessment by anesthesiologist and pediatrician, temperature regulation prior surgery and placement of thermal blanket, endotracheal general anesthesia was performed with ketamine on both twins, and manual ventilation through air t with a 40 Fr cycles per minute. Anesthetic maintenance was performed with ketamine for not having nitrous oxide and muscle relaxants.
Results: siamese 1 suffered hemodynamic instability, intraoperative hypoxemia and cardiac arrest and she needed CPR which resulted in successful brain reanimation, restoring cardiac and respiratory stability and urine output. Postoperative cerebral protection measures were taken. Siamese 2 had no intraoperative anesthetic or surgical complications.
Conclusions: The separation of both conjoined twins was successfully achieved with satisfactory outcome. It is the first case of conjoined twins separated in Angola and both survived. Currently they are 24 months old with no sequelae.

REFERENCES

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