Anesthetizing the obese child

Summary The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases. T...

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Bibliographic Details
Published in:Pediatric anesthesia 2011-06, Vol.21 (6), p.623-629
Main Authors: Mortensen, Anette, Lenz, Katja, Abildstrøm, Hanne, Lauritsen, Torsten L. B.
Format: Article
Language:English
Subjects:
Adolescent
airway
Airway Management
Anesthesia
Anesthetics - pharmacokinetics
Anesthetics - pharmacology
Body Weight - physiology
Child
comorbidity
Humans
obesity
Obesity - complications
Obesity - epidemiology
Obesity - etiology
Obesity - physiopathology
pediatric
pharmacokinetics
Postoperative Care
Preoperative Care
Sleep Apnea, Obstructive - complications
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Summary:Summary The prevalence of childhood obesity is increasing. The focus of this review is the special anesthetic considerations regarding the perioperative management of obese children. With obesity the risk of comorbidity such as asthma, obstructive sleep apnea, hypertension, and diabetes increases. The obese child has an increased risk of perioperative complications especially related to airway management and ventilation. There is a significantly increased risk of difficult mask ventilation and perioperative desaturation. Furthermore, obesity has an impact on the pharmacokinetics of most anesthetic drugs. This has important implications on how to estimate the optimal drug dose. This article offers a review of the literature on definition, prevalence and the pathophysiology of childhood obesity and provides suggestions on preanesthetic evaluation, airway management and dosage of the anesthetic drugs in these patients. The authors highlight the need of supplemental studies on various areas of the subject.
ISSN:1155-5645
1460-9592
DOI:10.1111/j.1460-9592.2011.03559.x