Anesthesia Management in Adolescent Bariatric Surgery

Abstract

Introduction and Purpose: The problem of obesity has started to increase in children and adolescents, similar to adults, due to irregular and unhealthy diet, the limitation of physical activity and genetic factors. Various difficulties and complications may be encountered in the anesthesia management of obese patients. Difficult airway, difficulty in intravenous and intra-arterial interven-tion, difficulty in positioning the patient, difficulty in finding suitable equip-ment for the patient, intraoperative and postoperative pulmonary complications, prolonged recovery and difficulty in patient transport are the points to be considered in perioperative management. In our presentation, we wanted to discuss perioperative anesthesia management in adolescent bariatric surgery, which is not performed frequently, with a case study. Case Presentation: A 16-year-old girl with BMI of 44.4 was evaluated for bariatric surgery due to obesity. She had a history of hypertension, sleep apnea and insulin resistance. In her physical examination, her mouth opening was normal, her Mallampati score was 3, and her neck circumference was 43 cm. After the preoperative difficult intubation preparations were completed, the patient was monitored. The patient was preoxygenated with 100% oxygen for 3 minutes. The patient with com-fortable mask ventilation was intubated with an appropriately sized endotra-cheal tube. Hemodynamics and oxygen saturation remained stable throughout the surgery. At the end of the surgery, she was extubated without any problem and transferred to the pediatric surgical intensive performed in obese patients. Although prevention of obesity is the mainstay of obesity treatment, bariatric surgery is also a safe and effective treatment method in adolescents.