Gezy Weita Giwangkancana1, Ezra Oktaliansyah1, Rulli Herman Sitanggang1
Conjoint Twin Separation Pain Management Case Series : A Multidisciplinary Approach on 4 Conjoined Twin Separation Surgery
Conjoined twins are a rare congenital anomaly and separation surgery is a challenging and complex process. A multi discipline approach is important to achieve ERAS (Enhanced Recovery After Surgery), We report 4 cases of conjoined twins ranging from 40 days until 3 years old that was separated from the year 2012-2016. An all cases a multi discipline approach was applied which included preoperative meetings, operation theatre planning and post operative pain management. All patient post surgery had multi modal pain management that included the use of both pharmacological and non pharmacological approach. A specialized team of pediatric intensivist, psychologist and social worker was involved. A special group of conjoined twin survivors also gave support to the parents in each surgery. The use of music, behavior therapy and role playing also reduced the use of pharmacological approach in each case.
Keywords : conjoined twins, pediatric anesthesia, post operative pain