Obese children face increased risks of perioperative complications, particularly difficult mask ventilation, desaturation, and altered pharmacokinetics requiring careful anesthetic dose estimation.
What are the special anesthetic considerations regarding the perioperative management of obese children?
Obese children require special anesthetic considerations due to increased risks of perioperative complications, difficult airway management, and altered pharmacokinetics.
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.
Mortensen et al. (2011) conducted a review in Childhood obesity. Anesthesia was evaluated. Obese children face increased risks of perioperative complications, particularly difficult mask ventilation, desaturation, and altered pharmacokinetics requiring careful anesthetic dose estimation.