Related Experiment Video
Updated: Mar 7, 2026
Anesthesia and Intubation of Preadolescent Mouse Pups for Cardiothoracic Surgery
Published on: June 2, 2022
Pilot study comparing post-anesthesia care unit length of stay in moderately and severely obese children
Hina Walia1, Onur Balaban2, Megan Jacklen3
1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA. hina.walia@nationwidechildrens.org.
Insights
Severely obese children had similar post-anesthesia care unit stays as moderately obese children, but were more likely to be admitted to the hospital. Further research is needed to identify factors influencing hospital admission for obese pediatric surgical patients.
Area of Science:
- Pediatric Surgery
- Obesity Research
- Anesthesiology
Background:
- Obesity is a known risk factor for surgical complications in both adults and children.
- Clear distinctions in postsurgical outcomes based on obesity severity (moderate vs. severe) in pediatric populations are not well-established.
Purpose of the Study:
- To compare post-anesthesia care unit (PACU) stay and hospital admission rates between severely obese and moderately obese children undergoing surgery.
Main Methods:
- Retrospective review of 1324 obese children (ages 2-18) undergoing surgery over a 6-month period.
- Multivariate mixed-effects regression analysis was employed to compare outcomes.
- Key outcomes assessed included PACU length of stay (LOS), need for opioid analgesia, and hospital admission.
Main Results:
- No significant difference in PACU LOS was observed between moderately obese (50 ± 36 min) and severely obese patients (55 ± 38 min).
- Opioid utilization in the PACU was comparable between the two obesity severity groups.
- Severely obese patients demonstrated a higher likelihood of requiring inpatient admission compared to moderately obese patients.
Conclusions:
- The average PACU stay for both groups was under 1 hour, suggesting outpatient management is feasible for most.
- Identifying comorbidities that may prolong PACU stay or lead to unplanned admissions in obese pediatric surgical patients is crucial.
- Younger age and surgical procedure complexity/duration may be factors contributing to prolonged PACU stays or hospital admissions.
Objective:
Obesity is a risk factor for surgical complications in adults and children. Differences in postsurgical outcomes according to severity of obesity [moderate: 95-98th age-gender-specific body mass index (BMI) percentile versus severe: ≥99th percentile] in children remain unclear. This study compared post-anesthesia care unit (PACU) stay and hospital admission between severely obese children and moderately obese children undergoing surgery.
Methods:
In a retrospective review over a 6-month period, obese children, 2-18 years of age undergoing surgery were identified. Multivariate mixed-effects regression was used to compare PACU length of stay (LOS) need for opioid analgesia, and hospital admission between moderately and severely obese patients.
Results:
There were 1324 records selected for inclusion. PACU LOS did not significantly differ between moderately obese (50 ± 36 min) and severely obese patients (55 ± 38 min). There were no differences between moderately and severely obese patients in use of opioids in the PACU. Yet, severely obese patients were more likely to require inpatient admission than moderately obese patients.
Conclusions:
The duration of PACU stay still averaged less than 1 h in our cohort, suggesting that the majority of these patients can be cared for safely in the outpatient setting. Future studies should focus on identifying the co-morbid conditions that may prolong postoperative PACU stay or result in unplanned hospital admission in moderately and severely obese patients. Our preliminary data suggest that these factors may include a younger age and the complexity or duration of the surgical procedure.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:21Drug Dosing: Obese Patients