Sato Yukari, Iura Akira, Kawamoto Yu, Yamamoto Shunsuke, Iritakenishi Takeshi, Fujino Yuji
Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
Department of Anesthesiology, Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
JA Clin Rep. 2021 Jan 6;7(1):6. doi: 10.1186/s40981-020-00406-8.
Conjoined twins are an extremely rare congenital occurrence, and anesthetic management for surgical separation presents unique challenges for anesthesiologists.
Five-month-old male pygopagus conjoined twins underwent separation surgery. We performed anesthesia induction in the supine position and surgery in the prone position. This presented a challenge because the transition from supine to prone position reversed the positional relationship between the two babies, resulting in crossing of the respiratory circuits and monitors. To solve the problem, we used anesthesia machines and monitors on the opposite side of each baby during anesthesia induction. The positional relationship between the twins and anesthesia machines and monitors normalized after the change to the prone position. Following the separation surgery, the twins were discharged without any complications.
Our method of using opposite side anesthetic machines and monitors for anesthesia induction was useful for the safe anesthetic management of pygopagus conjoined twins.
联体双胎是一种极其罕见的先天性疾病，手术分离的麻醉管理给麻醉医生带来了独特的挑战。
一对5个月大的男性骶部联体双胎接受了分离手术。我们在仰卧位进行麻醉诱导，在俯卧位进行手术。这带来了一个挑战，因为从仰卧位到俯卧位的转变颠倒了两个婴儿之间的位置关系，导致呼吸回路和监测仪交叉。为了解决这个问题，我们在麻醉诱导期间在每个婴儿的对侧使用麻醉机和监测仪。转换到俯卧位后，双胞胎与麻醉机和监测仪之间的位置关系恢复正常。分离手术后，双胞胎顺利出院，无任何并发症。
我们在麻醉诱导时使用对侧麻醉机和监测仪的方法，对联体双胎的安全麻醉管理是有用的。
