Anesthesia for Pygopagus Conjoined Twins During Single-Twin and Simultaneous Pneumoperitoneum: A Case Report. Issue 3 (1st August 2018)

• Record Type: Journal Article
• Authors: Sara, John-Paul; Kydes, Ashley; Pryjdun, Olena; Jacoby, Michael; McBride, Whitney; Pandya, Samir; Barst, Samuel
• Is Part Of: A & A practice. Volume 11:Issue 3(2018)
• Publication Date: 2018-08-01
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000000739
• Languages: English
• ISSNs: 2575-3126

Abstract

Abstract : We present the case of the first stage of separation of 9-month-old pygopagus conjoined twins who demonstrated minimal shared vasculature on preoperative imaging and no cross-sedation or cross-neuromuscular blockade during separate inductions of anesthesia. Laparoscopy was implemented in 1 twin at a time, then in both twins simultaneously. Despite insufflation of a single-twin's abdomen, both twins demonstrated hypercapnia and signs of a concomitant respiratory acidosis because of carbon dioxide diffusion through a shared peritoneal membrane. This is the first documented case of simultaneous laparoscopy-induced pneumoperitoneum in pygopagus conjoined twins.