WEDNESDAY, Oct. 19 (HealthDay News) -- Obese children need
special attention when they undergo anesthesia, two new studies
In one study, researchers found that obese children with asthma
suffer more complications from anesthesia than normal weight
children with asthma. In the other study, researchers found that
obese children require less of one type of anesthesia than normal
If a child is obese, has asthma or both, parents should expect
close monitoring, said researcher Dr. Olubukola Nafiu, an assistant
professor of pediatric anesthesiology at the University of
"Children who are obese and asthmatic have a twofold increased risk of developing respiratory problems when they are given anesthesia," Nafiu said.
Both studies are scheduled for presentation Monday at the annual
meeting of the American Society of Anesthesiologists in
To determine if complications were more frequent among obese
kids with asthma, Nafiu looked at 1,102 children and teens, aged 6
to 18, after anesthesia and divided them into four groups. One
group was obese and had asthma, one group was normal weight with
asthma, another was obese without asthma, and the last group was
normal weight without asthma.
Those in the obese-asthmatic and obese non-asthmatic groups were
more likely to have critical airway problems, such as spasms, than
their thinner peers, the study found, but there were no fatal
complications among the study patients.
Both obesity and asthma are known to be independent risk factors
for respiratory problems during anesthesia, Nafiu said. Both
conditions are increasing in U.S. children at an alarming rate, and
the researchers wanted to find out if complications are more
frequent in pediatric patients who have the two disorders.
Respiratory problems are a leading cause of complications,
including death, during pediatric surgery, the authors said.
In a second study, Dr. Olutoyin Olutoye, of Texas Children's
Hospital in Houston, found that obese children require smaller
doses of the anesthetic propofol than their slimmer peers.
According to Olutoye, doctors have known that obese adults need
less propofol than normal weight adults, but whether that applied
to obese children was unclear. Since propofol can cause low blood
pressure and reduced breathing, it's important not to administer
too much, the researchers noted in a news release from the American
Society of Anesthesiologists.
The study included 40 obese and 40 normal weight children. The
investigators measured each child's response 20 seconds after
getting propofol. The normal weight kids needed 50 to 60 percent
more of the anesthetic than the obese children.
In obese children, 75 percent of excess body weight is fat
tissue, which can alter the distribution of propofol in the body,
the researchers explained.
Additional studies involving children are needed to determine
how obesity affects other anesthetic medications, Olutoye said.
"These studies confirm the general impression that anesthesiologists already have about obese children," said Dr. Mark Singleton, chair of the American Society of Anesthesiologists' committee on pediatric anesthesia, who was not involved with the study.
The message from the asthma and obesity study is, "Kids with
asthma and obesity are at double jeopardy," Singleton said.
However, he pointed out that the anesthesia-dose research only
involved the drug propofol, which is injected, and would not apply
to other drugs. Most children's anesthesia is induced by
inhalation, Singleton noted.
Doctors should obtain children's height and weight to see if
they fall within the obese range, Nafiu added. A body mass index
(BMI) in the 95th percentile or above is considered obese.
Parents of obese and/or asthmatic children should expect
numerous questions from the doctor before their child undergoes
surgery that requires anesthesia, and they should expect especially
close monitoring, he added.
Because the research was presented at a medical meeting, it
should be considered preliminary until published in a peer-reviewed
To help prepare your child for anesthesia, visit the
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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