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The Anesthetic Management of an Adolescent with Autism Spectrum Disorder and Super-Super Obesity: a Case Report

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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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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada

    Deric B. Diep

  2. Anesthesiologist and Intensivist, The Ottawa Hospital, Ottawa, Canada

    Jonathan Hooper

  3. Anesthesiologist and Clinical Lead (Bariatric Anesthesia), The Ottawa Hospital, 1053 Carling Avenue, Suite B310, Ottawa, ON, K1Y4E9, Canada

    Naveen Eipe

Authors
  1. Deric B. Diep
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  2. Jonathan Hooper
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  3. Naveen Eipe
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Contributions

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.

Corresponding author

Correspondence to Naveen Eipe.

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The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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This article does not contain any studies with animals performed by any of the authors.

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This article is part of the Topical Collection on Surgery

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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

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