Citation

Holzman RS. Curr. Opin. Anaesthesiol. 2013; 26(3): 333-339.

Copyright

(Copyright © 2013, Lippincott Williams and Wilkins)

DOI

10.1097/ACO.0b013e32835e7507

PMID

unavailable

Abstract

PURPOSE OF REVIEW: To describe adolescent development within the context of perioperative anesthetic management. RECENT FINDINGS: Most adolescent deaths are as a result of unintentional injury. Motor vehicle accidents are the most common cause, with homicide the second most common cause of intentional injury. Suicide is also a significant cause of adolescent death. The thinning of gray matter following preadolescence overtakes synaptogenesis, resulting in a more efficient, adult-like brain. Although adolescent substance use has declined over the last 30 years, cigarette smoking, alcohol and illicit drug use, sexual activity, and violent behavior remain significant concerns in perioperative care. The tremendous increase in physical working capacity and maximum oxygen consumption during adolescence commonly results in the pursuit of muscularity, substance use and abuse, dieting regimens, and muscle dysmorphia. Childhood obesity has risen by more than 50% in the last 10 years. Anorexics die at a rate of 10-20% from complications of starvation or from suicide. Up to 8% of adolescents are diagnosed with major depressive disorder. Poorly controlled perioperative pain is still common. Many adolescents have decision-making capacity and therefore assent to surgery becomes an important perioperative consideration. SUMMARY: Adolescents are a very healthy population subject to unintentional and intentional injury. Emotional and judgmental maturation is a cofactor in these injuries, better appreciated through improved understanding of developmental neurobiology. In addition, increases in muscle mass, requirements for nutrition and rest, maladaptive behavior, and health choices are important for optimal perioperative care. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Language: en

Keywords

Humans; Risk Factors; adolescent; Child; human; violence; Adolescent; homicide; suicide; child; brain; Magnetic Resonance Imaging; adolescence; Adolescence; nutrition; traffic accident; major depression; Obesity; trends; Brain; Anorexia; Adolescent Medicine; Substance abuse; risk factor; review; substance abuse; alcohol consumption; anorexia; sexual behavior; smoking; priority journal; nuclear magnetic resonance imaging; physiology; child health care; illicit drug; neurobiology; emotional stability; medicine; clinical decision making; Anesthesia; childhood mortality; anesthesia induction; procedures; synaptogenesis; muscle mass; gray matter; complex regional pain syndrome; rest; growth, development and aging; muscle malformation; Perioperative Care; perioperative period; childhood obesity; Emancipated minor; Pediatric Obesity