Anaesthetists struggling with dose sizes in childhood obesity cases
ANAESTHETISTS are battling to find the correct doses and drugs to help obese children safely through operations due to their ever-increasing size.
Calls for a national taskforce to tackle paediatric obesity emerged from a national conference of anaesthetists amid growing concerns for children’s safety during and recovering from routine surgeries.
Melbourne paediatric anaesthetist Balvindar Kaur said the growing size of Australian children not only compromised their health, but strained medical resources as extra staff and specialist beds were required.
“Children have a relatively higher metabolic rate than adults — higher heart rate and other outputs — and while we generally dose by weight you can’t give a 90kg child what you might administer to a 90kg adult,” Dr Kaur said.
“I’ve had a 70kg 10-year-old in the last week, and one of my colleagues had a 60kg six-year-old, and this is just in our day-to-day practice.
“This is the reality, this is what we are seeing.”
Obese children are 27 times more likely to have type 2 diabetes than a child with healthy weight, twice as likely to have hypertension and obstructive sleep apnoea, and also have a significantly higher chance of suffering asthma and gastric reflux.
Dr Kaur told the Australian and New Zealand College of Anaesthetists’ annual meeting in Adelaide that obese children posed challenges in finding appropriate anaesthetic and analgesic dosage, while the increased work meant day surgeries had to become prolonged hospital stays.
“Afterwards there are issues of where they go and having them stay overnight which puts a burden on hospital resources,” Dr Kaur said.
With one in five Australian children obese, Dr Kaur called for a taskforce of physicians, educators and health policymakers to work towards halting the epidemic. “We need a collaborative effort which addresses this from all aspects,” she said.
“We (anaesthetists) are in a unique position as physicians because we can educate parents and patients when we meet them, but we can’t tackle the problem ourselves.
“As physicians we all have a role to play in providing information about health to parents, and I guess sometimes they may not be aware of it being a problem.”