Safety and Quality Issues in NORA (Non-Operating Room Anaesthesia)

Abstract

Off -site anaesthesia (non-operating room anaesthesia) encompasses all sedation/anaesthesia provided by anaesthesiology services outside of the operating room environment. Anaesthesia providers are now asked more frequently to provide complete, integrated anesthetic care outside the traditional OR setting. Over the past few decades, requests for these services in remote locations have been steadily increasing. The sites at which services are needed include- radiology suites, interventional neuroradiology labs, oocyte retrieval, cardiac cath labs, electro convulsive therapy, oncology wards, endoscopy suites and the list is increasing day by day. Problems faced by the Anaesthesiologists are- Lack of adequate space, Unfamiliar surroundings and equipments, Central pipeline will be missing and cylinders will have to be used, Unphysiological postures needed for some procedures, Out patients for investigations are inadequately prepared/investigated/have associated medical illness, Adverse reactions to contrast media and lack of post anaesthetic care.