73 - Non-Operating Room Anesthesia

Abstract

The non-operating room arena represents an expanding perimeter of anesthetic practice. As technology advances and patient acuity increases, non-operating room anesthesia (NORA) cases have become more demanding in terms of both patient management and necessary resources. Financial and operational constraints create additional challenges. Significant differences in practice result from the fact that NORA cases occur in places remote from the operating room (OR) and are performed frequently by medical proceduralists who are less acquainted with the scope of anesthesiology practice. In addition, anesthesiologists may be less familiar with the demands of providing an anesthetic in an environment in which equipment restricts mobility and access to patients, setups distinct from the OR are utilized, and where radiation hazards are significant. This chapter serves as a general guide to the cadence and focus of procedures performed outside of the OR, and highlights some of the adaptations, both cultural and practical, that are needed to provide a safe and optimal anesthetic.