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Abstract Overweight children become obese adults. Overweight and obesity are associated with serios medical, physiological, and social problems. Increasing the rate of obesity among children is one of the most challenging dilemma facing pediatric care professionals today with its consequent morbidity and mortality, that is caused by a caloric intake that is greater than needed. Obesity is included in the following syndromes; Prader-Willi syndrome, Alstrom syndrome, Beckwith syndrome, Bardet Biedl syndrome, Carpenter syndrome, and Chuppy Puffer syndrome. Obese children are at high risk of diabetes mellitus type II, cardiovascular complications such as hypertension, tachycardia, arrhythmias, blood loss, and left ventricular failure. They are also at risk of respiratory complications such as hypoxemia, laryngospasm, obstructive sleep apnea, decrease in gas exchange, and decrease in the functional residual capacity in comparison with the non-obese ones. This essay discusses overweight/obesity and gastric fluid characteristics in pediatrics surgery and implication of the fasting guidelines and pulmonary aspiration risk related to emetic episodes associated with shortened fasting intervals. This essay also discusses the safest anesthetic techniques in those obese pediatrics, pre-operative assessment, intra-venous access, pre-medications, positioning, monitoring and management of complications intra and postoperatively. |