Jency Jacob

Date of Award


Document Type

Independent Study

Degree Name

Master of Science (MS)


Title: Anesthesia implications of pediatric obesity

Background: Pediatric obesity is becoming an epidemic nationally and internationally. It poses several challenges to anesthesia providers because of the comorbidities associated with it. Anesthesia challenges posed by a 3-year-old obese patient led this author to do an independent study on pediatric obesity and anesthesia management.

Purpose: The purpose of this independent study is to review the current literature, epidemiology, comorbidities and practice recommendation regarding the anesthetic management of pediatric obese patients.

Process: A comprehensive literature review was conducted utilizing the University of North Dakota's Harley. E. French library web~i.te. Current literatures was searched using the key words 'pediatric anesthesia' and 'obesity'. Search engines such as PubMed, ClinicalKey and CINAHL were used. Journals were extensively reviewed for relevant inforn1ation.

Results: The findings presented in the study are based on the published literatures in the year range of2005-2012. This paper will evaluate what the literature states about the prevalence and the pathophysiology of childhood obesity and provides suggestions on pre-anesthetic evaluation, airway management, dosage of anesthetic drugs, and postoperative care.

Implications: Perioperative respiratory events seem more frequent in overweight and obese children. So anesthetist should anticipate and be prepared to optimize the anesthetic management of this high-risk population. Increasing number of pediatric obese surgical population demands more researches in areas of pharmacology, preoperative and intraoperative management.

Kcywords :yediatric, obesity, anesthesia, management

Childhood obesity is increasing substantially in industrialized nations, which poses multiple medical and social issues. Worldwide obesity has more than doubled since 1980, and approximately 43 million children under the age of five were overweight in 2010 (Owen & John, 2012). According to statistics, in United States the incidence of obesity in 6-11 year-olds increased by 54 % in the last tlu·ee decades and approximately one third of patients presenting to pediatric day surgery units are overweight or obese (Middlebrooks & Winters, 2011). Obesity is a systemic disease process that alters the physical and mental health of the pediatric patient. Because of comorbidities associated with obesity, the intra-operative and post-operative course is challenging to anesthesia care providers. Respiratory complications, airway management difficulties, prolonged post anesthesia care unit (P ACU) stays and postoperative nausea and vomiting (PONY) are more common with an elevated body mass index (BMI). Because of these consequent challenges, obese pediatric population demands more plaiming, consultations, management and time.