J Ulrici1, G Hempel1, M Sasse2, J Vollrath3, C Höhne4. 1. Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland. 2. Klinik für Intensivmedizin, HELIOS Park-Klinikum Leipzig, Leipzig, Deutschland. 3. Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig, Leipzig, Deutschland. 4. Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland. Claudia.Hoehne@medizin.uni-leipzig.de.
Abstract
BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed. With the aid of special data sheets, the following parameters were determined: Mallampati Score, difficult mask ventilation and intubation, use of a Guedel/Wendl tube, Cormack-Lehane Score, number of intubation attempts, airway obstructions (broncho- and laryngospasms), coughing as a sign of airway irritation, and decreases in oxygen saturation >10 %. RESULTS: Overweight and obese children had a significantly higher Mallampati Score and a significantly higher prevalence of coughing (p < 0.05). None of the other parameters showed any significant differences between the groups. However, the incidence of desaturation was 9.5 % in overweight children and 6.3 % in children of normal weight, and that of airway obstructions was 4.1 vs 2.7 %. CONCLUSION: This study demonstrated a very low incidence of respiratory problems, which may be caused by the low proportion of morbidly obese children and the older age of overweight children in comparison with other studies.
BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed. With the aid of special data sheets, the following parameters were determined: Mallampati Score, difficult mask ventilation and intubation, use of a Guedel/Wendl tube, Cormack-Lehane Score, number of intubation attempts, airway obstructions (broncho- and laryngospasms), coughing as a sign of airway irritation, and decreases in oxygen saturation >10 %. RESULTS: Overweight and obesechildren had a significantly higher Mallampati Score and a significantly higher prevalence of coughing (p < 0.05). None of the other parameters showed any significant differences between the groups. However, the incidence of desaturation was 9.5 % in overweight children and 6.3 % in children of normal weight, and that of airway obstructions was 4.1 vs 2.7 %. CONCLUSION: This study demonstrated a very low incidence of respiratory problems, which may be caused by the low proportion of morbidly obesechildren and the older age of overweight children in comparison with other studies.
Authors: Olubukola O Nafiu; Glenn E Green; Sarah Walton; Michelle Morris; Sudheera Reddy; Kevin K Tremper Journal: Int J Pediatr Otorhinolaryngol Date: 2008-11-08 Impact factor: 1.675