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Anesthetic and pharmacologic considerations in perioperative care of obese children

Vidya Chidambaran1, Anurag Tewari2, Mohamed Mahmoud1

  • 1Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Journal of Clinical Anesthesia
|December 25, 2017
PubMed

Insights

Managing anesthesia in obese children presents challenges due to obesity-related comorbidities. This review details the impact of pediatric obesity on perioperative care and drug dosing for safer anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Obesity Medicine

Background:

  • Childhood obesity is rising, increasing the number of severely obese children requiring surgery.
  • Obese children often present with comorbidities that elevate perioperative risks.

Purpose of the Study:

  • To provide a comprehensive review on the effects of pediatric obesity on perioperative management.
  • To offer updated guidance on anesthetic drug dosing for obese children.

Main Methods:

  • A narrative review of peer-reviewed manuscripts from MEDLINE and PubMed.
  • Inclusion of adult studies when pediatric data was unavailable.

Main Results:

  • Obesity in children is defined by age- and sex-specific body mass index percentiles.
  • Comorbidities like obstructive sleep apnea, respiratory, and cardiovascular issues are prevalent and increase surgical risk.
  • The review discusses the impact of obesity on anesthetic pharmacokinetics and provides dosing recommendations.

Conclusions:

  • Safe anesthetic management requires thorough pre-procedure assessment and tailored perioperative care.
  • Heightened awareness of complications and individualized drug dosing are crucial.
  • Further guidelines are needed for risk stratification, drug dosing, and postoperative care in obese pediatric patients.
Abstract

Keywords:
Anesthesia considerationsObesityPathophysiologyPediatricPharmacologySeverely Obese

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