Samuels Paul J, Sjoblom Matthew D
Cincinnati Children's Hospital, Cincinnati, Ohio, USA.
Curr Opin Anaesthesiol. 2016 Jun;29(3):327-36. doi: 10.1097/ACO.0000000000000330.
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.
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.
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.
小儿肥胖在我们的临床实践中已很常见,给麻醉医生带来了诸多挑战。本研究对小儿肥胖患者的围手术期护理进行了最新综述,包括小儿肥胖的测量、肥胖儿童的合理药物剂量以及青少年减肥手术结果的最新数据。
小儿肥胖与许多影响麻醉护理的相关合并症有关,特定儿童的风险尤其高。该患者群体的药物剂量问题仍然存在,并给出了有关适当给药的最新证据。青少年减肥手术已从胃旁路手术转向袖状胃切除术,效果相当。
肥胖儿童的安全有效护理需要精心的围手术期管理。高危儿童尤其脆弱,需要特别关注。减肥手术是对重度肥胖青少年的有效干预措施。