Anaesthetic managements for conjoined twins with complex cardiac anomalies

Ta-Liang Chen, C. J. Lin, H. S. Lai, W. J. Chen, C. C. Chao, C. C. Liu

研究成果: 雜誌貢獻文章

7 引文 斯高帕斯(Scopus)

摘要

Purpose: To describe the perioperative assessment and anaesthetic management for surgical separation of three sets of conjoined twins with complex cardiac anomalies threatened with arterial desaturation and haemodynamic instability. Clinical features: Three sets of conjoined twins, one omphaloischiopagus, one omphalopagus, and one thoraco-omphalopagus, were considered for separation during the perinatal or infantile period. Preoperative functional evaluation including continuous pulse oximetry, capnography, and cardiac electrophysiological studies were considered to be as important as anatomical evaluation of the cardiac anomalies and cross-circulation by angiography in assessing the feasibility of surgical separation. Ipsilateral infusion of prostaglandin E1 and phenylephrine were applied to the cyanotic and healthy twins respectively, to restore arterial oxygenation intraoperatively and to avoid profound hypoxaemia. Conclusion: Surgical separation and anaesthesia should be well planned and rehearsed before clinical deterioration of the weaker twin. Aggressive pharmacological intervention and understanding of the cross-circulation pathophysiology is necessary to manage critical situations during surgical separation and in the postoperative period.

原文英語
頁(從 - 到)1161-1167
頁數7
期刊Canadian Journal of Anesthesia
43
發行號11
DOIs
出版狀態已發佈 - 十一月 1996
對外發佈Yes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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