Anesthetic Management for Surgical Separation of Xipho-omphalopagus

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 9; no. 3; pp. 260 - 265
• Main Authors: ISONO, Shiroh, SUGIMORI, Kunio, GOTANDA, Jun, HASEGAWA, Kouhei, UCHIDA, Haruo, HATORI, Fumimaro
• Format: Journal Article
• Language: English
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 1989
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.9.260

Anesthetic management for surgical separation of xipho-omphalopagus is described. Preoperatively, examinations were performed to define organ sharing and to demonstrate coexisting cogenital anomalies, and perioperative problems were thoroughly discussed among the departments concerned. Furthermore, rehearsal of the separation procedure in the operating room was very helpful. We chose high-dose fentanyl anesthesia with oxygen and air which released us from the hazard of large anesthetic machines. It was also very useful in avoiding bowel distention and decreasing abdominal pressure. Mechanical ventilators with co-axial circuits were useful in their lightness and simpleness. Blood loss was well reflected by central venous pressure monitoring and was always underestimated by weighing of sponges. When the patients were turned to supine posture, they showed hypotension and tachycardia, perhaps, due to vasodilation in addition to inadequate blood replacement. Their postoperative courses were uneventful and they were discharged home on the 30th postoperative day. We ascertained the importance of close planning of anesthetic management which will save a lot of time and increase the degree of safety.