Abstract
We report the anesthetic management of a 15-year-old patient with super-super obesity (SSO) and autism spectrum disorder (ASD) presenting for dental surgery and debridement of ingrown toe nails. We discuss the major perioperative implications of SSO and ASD with special attention to the challenges of the morbid obesity difficult airway (MODA). We describe a pragmatic approach for managing MODA—predict difficulty, plan and prepare appropriate equipment, position and preoxygenate the patient, making appropriate pharmacological choices, and continue attention to airway and respiration in the postoperative period. The perioperative implications of a complex combination of ASD with SSO require a multidisciplinary approach with adequate experience, expertise, and equipment.
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Deric B Diep: was involved in the care of the patient, obtained consent, reviewed literature, and prepared preliminary case report.
Jonathan Hooper: was involved in the care of the patient, contributed to the discussion, and reviewed the entire manuscript.
Naveen Eipe: was involved in the care of the patient, prepared the case report, and prepared and submitted the final manuscript.
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Diep, D.B., Hooper, J. & Eipe, N. The Anesthetic Management of an Adolescent with Autism Spectrum Disorder and Super-Super Obesity: a Case Report. SN Compr. Clin. Med. 1, 841–845 (2019). https://doi.org/10.1007/s42399-019-00136-8
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DOI: https://doi.org/10.1007/s42399-019-00136-8
Keywords
- Patient-pediatric
- Adolescent
- Autism spectrum disorder
- Patient cooperation
- Parental presence at induction
- Distraction
- Obesity
- Obesity-body mass index (BMI)
- Super-super obesity (SSO)
- Morbid obesity (MO)
- Morbid obesity-anesthetic induction
- Drug dosing
- Airway management
- Airway management-anticipated difficult
- Morbid obesity difficult airway (MODA)