Anesthesia Considerations for Adolescent Bariatric Surgery

Pediatric obesity has become an increasingly encountered diagnosis. Higher rates of obesity in children and adolescents, combined with the recent knowledge that many of the adult comorbidities of obesity have their roots in childhood, has made pediatric obesity a subject of research. Almost every organ system is affected by obesity. When conservative measures such as diet and exercise are ineffective, carefully selected patients are considered for one of several bariatric surgery procedures. The goal is to decrease the patient’s weight to healthier levels prior to the onset of significant comorbid conditions. Anesthesia for these procedures requires a knowledge of the pathophysiology of obesity, an acknowledgement of the typically encountered issues with pediatric/adolescent patients, an understanding of the surgical technique’s requirements from the anesthesia team and a command of the pharmacologic effects of the anesthetic medications used in this population.