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Anaesthetic considerations for separation of omphalo-ischiopagus tripus twins


Anaesthesia for the separation of conjoined twins requires a multi-disciplinary team approach. We describe the anaesthetic management of a single-stage separation of 2 1/2 A-year-old omphalo-ischiopagus tripus conjoined twins. The successful 17 1/2-hour operation was conducted by five anaesthetists and 38 surgeons and nurses. Two major problems were encountered: massive blood loss in both twins (requiring transfusions of more than five and seven times their blood volumes) and a transient decrease in core temperatures after separation.


L’ anesthésie pour la séparation de jumeaux siamois requiert une approche multidisciplinaire. On décrit la conduite anesthésique pour des omphalo-ischiopagus tripus âgés de 2 1/2 ans. L’ opération a duré 17 1/2 heures et a été menée par cinq anesthésistes et 38 chirurgiens et infirmières. L’ opération était couronnée de succès. Cependant deux problèmes majeurs ont été rencontrés: L’ hémorragie massive requérant des transfusions supérieures à 5 et 7 fois leur volume sanguin et une diminution transitoire de ta température centrale corporelle après la séparation.


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Correspondence to P. D. James or J. Lerman or M. E. McLeod or J. E. S. Relton or R. E. Creighton.

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James, P.D., Lerman, J., McLeod, M.E. et al. Anaesthetic considerations for separation of omphalo-ischiopagus tripus twins. Can Anaesth Soc J 32, 402–411 (1985). https://doi.org/10.1007/BF03011351

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Key words

  • anaesthetics: paediatric
  • genetic factors: conjoined twins