TORONTO — Obesity did not increase the risk of adverse airway events associated with procedural sedation and analgesia in the emergency department in one large study.
The study of 1,112 patients between the ages of 0 and 21 years, 15% of whom were obese, was presented by Dr. Francesca Bullaro of Children's Hospital of Pittsburgh during a poster session at the annual meeting of the Pediatric Academic Societies.
Obese children may be at increased risk for partial or complete upper airway obstruction during sleep as a result of obstructive sleep apnea. No published studies have evaluated airway adverse events occurring in obese children during procedural sedation and analgesia (PSA) in the emergency department, Dr. Bullaro said.
To determine the incidence of airway adverse events during PSA in obese children, Dr. Bullaro and her colleagues conducted a secondary analysis of prospectively enrolled patients from a procedural sedation database. Obesity was defined as weight in the 95th percentile or higher for age and gender using Centers for Disease Control and Prevention growth charts.
Adverse airway events were seen in 179 of 1,112 patients (16%). These included hypoxia in 166, vomiting in 12, stridor in 5, apnea in 3, and laryngospasm in 1. Some patients had more than one adverse event.
Of the obese patients, 17% experienced an adverse airway event, not significantly more than nonobese patients (16%). In particular, in obese patients, the incidence of hypoxia was 90% versus 93% in nonobese patients, which was not a significant difference.