Perioperative respiratory adverse events during ambulatory anesthesia in obese children

Obesity is one of the most common clinical conditions in the pediatric population with an increasing prevalence ranging from 20 to 30% worldwide. It is well known that during ambulatory anesthesia, obese children are more prone to develop perioperative respiratory adverse events (PRAEs) associated w...

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Bibliographic Details
Published in:Irish journal of medical science 2022-06, Vol.191 (3), p.1305-1313
Main Authors: Marjanovic, Vesna, Budic, Ivana, Golubovic, Mladjan, Breschan, Christian
Format: Article
Language:English
Subjects:
Anesthesia
Anesthetics - adverse effects
Child
Family Medicine
General Practice
Humans
Internal Medicine
Medicine
Medicine & Public Health
Pediatric Obesity - complications
Respiration, Artificial
Respiratory System
Review
Review Article
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Summary:Obesity is one of the most common clinical conditions in the pediatric population with an increasing prevalence ranging from 20 to 30% worldwide. It is well known that during ambulatory anesthesia, obese children are more prone to develop perioperative respiratory adverse events (PRAEs) associated with obesity. To avoid or at least minimize these adverse effects, a thorough preoperative assessment should be undertaken as well as consideration of specific anesthetic approaches such as preoxygenation before induction of anesthesia and optimizing drug dosing. The use of short-acting opioid and nonopioid analgesics and the frequent implementation of regional anesthesia should also be included. Noninvasive airway management, protective mechanical ventilation, and complete reversion of neuromuscular blockade and awake extubation also proved to be beneficial in preventing PRAEs. During the postoperative period, continuous monitoring of oxygenation and ventilation is mandatory in obese children. In the current review, we sought to provide recommendations that might help to reduce the severity of perioperative respiratory adverse events in obese children, which could be of particular importance for reducing the rate of unplanned hospitalizations and ultimately improving the overall postoperative recovery.
ISSN:0021-1265
1863-4362
1863-4362
DOI:10.1007/s11845-021-02659-3