March 3, 2026Open Access

Perioperative care in children with obesity. A narrative review

Key Result

Surgical procedures in children with obesity have increased by 25%, and severe obesity raises perioperative complication risk, necessitating individualized, multidisciplinary care.

Key Points

Increased awareness of perioperative care is essential given the rising rates of childhood obesity and surgical procedures.
A 25% increase in surgeries emphasizes the need for individualized risk assessment and management plans for children with obesity.
Comorbidities associated with severe obesity highlight the importance of a comprehensive multidisciplinary team approach.
Drug dosing adjustments are necessary due to pharmacokinetic changes in obese children, impacting surgical outcomes.

Structured PICO

What are the current evidence and recommendations for the perioperative management of children with overweight and obesity?

Population

Children with overweight and obesity requiring surgical procedures

Intervention

Perioperative management including diagnostic assessment, preoperative preparation, intraoperative and postoperative care, and drug dosing adjustments

Individualized perioperative care and a multidisciplinary approach are essential to minimize surgical risks in children with obesity.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

• Childhood obesity has tripled in the last 30 years, it is a public health concern. • Surgical procedures in children living with obesity have increased by 25%. • Individualized risk assessment and comorbidities are essential before surgery. • Drug dosing must be tailored to obesity-related pharmacokinetic changes. • Severe obesity has a higher complication rate, demanding multidisciplinary team. Childhood obesity is a complex chronic disease characterized by the pathological accumulation of adipose tissue, which has direct and deleterious effects on the structure and function of multiple organs and systems. Its increasingly high global prevalence has become a major public health concern particularly in regions such as Latin America and the Caribbean. This problem has also been associated with an increasing number of children requiring surgical procedures, posing new challenges to perioperative care. A thorough preoperative evaluation and an individualized management plan are essential to minimize risks and complications in this vulnerable population, with particular attention on the identification and assessment of comorbidities. This narrative review summarizes current evidence on the perioperative management of children with overweight and obesity, addressing diagnostic assessment, preoperative preparation, intraoperative and postoperative care, and drug dosing adjustments based on obesity-related pharmacokinetic alterations. Emphasis is placed on a comprehensive, multidisciplinary approach to ensure safe and effective surgical outcomes.