An article in the March issue of Anesthesiology reports that obese children are more likely to have problems during surgery. Specifically, obese children are more prone to problems with airway obstruction and other functions pertaining to breathing compared to normal-weight children. They had higher rates of difficult mask ventilation, airway obstruction, and major oxygen desaturation – a decrease in blood oxygen levels.

Researcher Alan R. Tait of the University of Michigan Health System and colleagues performed a large-scale prospective study to analyze the effects of overweight and obesity on the results of children undergoing elective non-cardiac surgery. Tait remarks, “To our knowledge, this is the first study of its kind.” The researcher argues that it is important to be aware of the higher risks of operating on obese children since it is highly likely that anesthesiologists will be caring for an increasing number of overweight and obese kids. In the United States, about 15% to 17% of children and adolescents are considered obese.

The researchers analyzed the surgeries of 2,025 children who were having elective surgery – 1,380 were normal weight, 351 were overweight, and 294 were obese. The participants were all between 2 and 18 years old.

Findings include:

  • 19% of obese children suffered from major airway obstructions (11% of normal-weight children did).
  • About 9% of obese children experienced difficult mask ventilation (2% of normal-weight children did).
  • 17% of obese children experienced major oxygen desaturation (9% of normal-weight children did).

Tait indicates that obese children were also more likely to have conditions that can contribute to problems during surgical operations: asthma, high blood pressure, sleep apnea, and Type II diabetes. For example, in the study, 28% of obese children had asthma compared to 16% of normal-weight children.

However, although obese children had a higher likelihood of adverse events during surgery, none resulted in severe illness.

Incidence and Risk Factors for Perioperative Adverse Respiratory Events in Children Who Are Obese
Alan R. Tait, Terri Voepel-Lewis, Constance Burke, Amy Kostrzewa, and Ian Lewis
Anesthesiology. 108(3):375-380, March 2008.
Click Here to View Abstract

Written by: Peter M Crosta