Anesthetic considerations for pediatric obesity and adolescent bariatric surgery.

ABSTRACT

PURPOSE OF REVIEW Pediatric obesity has become commonplace in our clinical practice, and presents anesthesia providers with numerous challenges. This study provides an up-to-date review of their perioperative care, including the measurement of pediatric obesity, rational drug dosing in obese children, and recent data on bariatric outcomes in adolescents. RECENT FINDINGS: Pediatric obesity is associated with a number of relevant comorbidities that impact anesthesia care, and specific children are at particularly high risk. Drug dosing remains problematic in this patient population, and recent evidence regarding appropriate drug administration is presented. Bariatric surgery in adolescents has shifted away from the roux-en-Y towards sleeve gastrectomy, with comparable results. SUMMARY: Safe and effective care of obese children demands careful perioperative management. High risk children are particularly vulnerable, and demand special attention. Bariatric surgery is an effective intervention for adolescents with severe obesity.