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Anestesia e desafios perioperátorios para cirurgia de separação de gêmeos toraco‐onfalópagos: relato de caso

dc.contributor.authorFreitas, Milton Halyson Benevides de
dc.contributor.authorLima, Luciana Cavalcanti [UNESP]
dc.contributor.authorCouceiro, Tania Cursino de Menezes
dc.contributor.authorCosta, Maria Célia Ferreira da
dc.contributor.authorFreitas, Márcio Handerson Benevides de
dc.date.accessioned2019-10-06T15:18:28Z
dc.date.available2019-10-06T15:18:28Z
dc.date.issued2019-03-01
dc.identifierhttp://dx.doi.org/10.1016/j.bjan.2018.06.005
dc.identifier.citationBrazilian Journal of Anesthesiology, v. 69, n. 2, p. 214-217, 2019.
dc.identifier.issn1806-907X
dc.identifier.issn0034-7094
dc.identifier.urihttp://hdl.handle.net/11449/186877
dc.description.abstractBackground and objectives: Conjoined twins are monozygotic twins physically joined at some part of the body. This is a rare phenomenon, estimated between 1:50,000 to 1:200,000 births. The objective of this report is to present the anesthetic management and the perioperative challenges for a separation surgery. Case report: Thoraco‐omphalopagus twins were diagnosed by ultrasound and were followed by the fetal medicine team of the service. After 11 hours of cesarean surgery, the pediatric surgical team chose to separate the twins. They were monitored with cardioscopy, oximetry, capnography, nasopharyngeal thermometer, urinary output, and noninvasive blood pressure. We chose inhaled induction with oxygen and 4% Sevoflurane. T1 patient was intubated with a 3.5 uncuffed endotracheal tube, and, after three unsuccessful intubation attempts of patient T2, a number 1 laryngeal mask was used. After securing the twins’ airway, the induction was supplemented with fentanyl, propofol, and rocuronium. Mechanical ventilation in controlled pressure mode (6 mL.kg ‐1 ) and lumbar epidural (L1‐L2) with 0.2% ropivacaine (2.5 mg.kg ‐1 ) were used. The pediatric surgical team initiated the separation of the twins via sternotomy, ligation of hepatic vessels. After 2 hours of procedure, the separation was completed, continuing the surgical treatment of T1 and the support of T2 until his death. Conclusions: Conjoined twin separation surgery is a challenge, which requires planning and coordination of a multidisciplinary team during all stages.en
dc.format.extent214-217
dc.language.isoeng
dc.language.isopor
dc.relation.ispartofBrazilian Journal of Anesthesiology
dc.sourceScopus
dc.subjectConjoined twins
dc.subjectMultidisciplinary care
dc.subjectPediatric anesthesia
dc.titleAnesthesia and perioperative challenges for surgical separation of thoraco‐omphalopagus twins: case reporten
dc.titleAnestesia e desafios perioperátorios para cirurgia de separação de gêmeos toraco‐onfalópagos: relato de casopt
dc.typeArtigo
dc.contributor.institutionUniversidade Federal de Pernambuco (UFPE)
dc.contributor.institutionInstituto de Medicina Integral Professor Fernando Figueira (IMIP)
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionUniversidade de Pernambuco (UPE)
dc.description.affiliationUniversidade Federal de Pernambuco (UFPE)
dc.description.affiliationInstituto de Medicina Integral Professor Fernando Figueira (IMIP)
dc.description.affiliationUniversidade Estadual Paulista (Unesp)
dc.description.affiliationUniversidade de Pernambuco (UPE)
dc.description.affiliationUnespUniversidade Estadual Paulista (Unesp)
dc.identifier.doi10.1016/j.bjan.2018.06.005
dc.rights.accessRightsAcesso aberto
dc.identifier.scopus2-s2.0-85051039114
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