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Obese, Asthmatic Kids Need Special Care Under Anesthesia
Date:10/19/2011

urgery, 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 questi
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