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Anesthesia considerations for pediatric metabolic and bariatric surgery.
Manupipatpong, Katherine; Wayne, Colton D; Tobias, Joseph D; Nafiu, Olubukola O; Michalsky, Marc P; Syed, Ahsan.
Afiliación
  • Manupipatpong K; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, and The Ohio State University, College of Medicine, Columbus, USA.
  • Wayne CD; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA.
  • Tobias JD; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, and The Ohio State University, College of Medicine, Columbus, USA.
  • Nafiu OO; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, and The Ohio State University, College of Medicine, Columbus, USA.
  • Michalsky MP; Department of Pediatric Surgery, Nationwide Children's Hospital and The Ohio State University, College of Medicine, Columbus, Ohio, USA.
  • Syed A; Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, and The Ohio State University, College of Medicine, Columbus, USA. Electronic address: Ahsan.Syed@nationwidechildrens.org.
Surg Obes Relat Dis ; 2024 Jul 11.
Article en En | MEDLINE | ID: mdl-39142958
ABSTRACT
Childhood obesity is a rapidly growing global health issue, linked to significant lifelong morbidity and mortality. Its impact on various organ systems increases perioperative complications. Obesity treatment in children and adolescents involves lifestyle, dietary, and behavioral modifications, as well as pharmacologic interventions that targets hormonal, metabolic, and neurochemical abnormalities. Metabolic and bariatric surgery, proven safe and effective for adults with severe obesity (class 2 or higher), is now being recommended for adolescents. Key anesthetic considerations for these surgeries include preoperative optimization, advanced airway management, targeted ventilation strategies, and opioid-sparing analgesic regimens. Comprehensive presurgical evaluations must address co-morbid conditions such as hypertension, obstructive sleep apnea, asthma, and impaired glycemic control. Preoperative management should also consider the effects of antiobesity medications on gastric emptying and hemodynamic stability. Ventilation strategies should prevent atelectasis while avoiding barotrauma, and drug dosages must be adjusted for altered pharmacokinetics due to increased adipose tissue. Employing enhanced recovery after surgery protocols may reduce perioperative complications, shorten postsurgical stays, and improve outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Surg Obes Relat Dis Asunto de la revista: METABOLISMO Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Surg Obes Relat Dis Asunto de la revista: METABOLISMO Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos