National trends in nonoperating room anesthesia: procedures, facilities, and patient characteristics.
Journal
Current opinion in anaesthesiology
ISSN: 1473-6500
Titre abrégé: Curr Opin Anaesthesiol
Pays: United States
ID NLM: 8813436
Informations de publication
Date de publication:
01 Aug 2021
01 Aug 2021
Historique:
pubmed:
3
6
2021
medline:
1
7
2021
entrez:
2
6
2021
Statut:
ppublish
Résumé
Nonoperating room anesthesia (NORA) continues to increase in popularity and scope. This article reviews current and new trends in NORA, trends in anesthesia management in nonoperating room settings, and the evolving debates surrounding these trends. National data suggests that NORA cases will continue to rise relative to operating room (OR) anesthesia and there will continue to be a shift towards performing more interventional procedures outside of the OR. These trends have important implications for the safety of interventional procedures as they become increasingly more complex and patients continue to be older and more frail. In order for anesthesia providers and proceduralists to be prepared for this future, rigorous standards must be set for safe anesthetic care outside of the OR.Although the overall association between NORA and patient morbidity and mortality remains unclear, focused studies point toward trends specific to each non-OR procedure type. Given increasing patient and procedure complexity, anesthesiology teams may see a larger role in the interventional suite. However, the ideal setting and placement of anesthesia staff for interventional procedures remain controversial. Also, the impact of COVID-19 on the growth and utilization of non-OR anesthesia remains unclear, and it remains to be seen how the pandemic will influence the delivery of NORA procedures in postpandemic settings. NORA is a rapidly growing field of anesthesia. Continuing discussions of complication rates and mortality in different subspecialty areas will determine the need for anesthesia care and quality improvement efforts in each setting. As new noninvasive procedures are developed, new data will continue to shape debates surrounding anesthesia care outside of the operating room.
Identifiants
pubmed: 34074883
doi: 10.1097/ACO.0000000000001022
pii: 00001503-202108000-00013
doi:
Substances chimiques
Anesthetics
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
464-469Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Références
Goudra BG, Singh PM. Out of operating room anesthesia: a comprehensive review 2016. Chapter 32: Future Research and Directions in Out of Operating Room Anesthesia; p. 453–458.
American Society of Anesthesiologists Committee on Standards and Practice Parameters (CSPP). Statement on Nonoperating Room Anesthetizing Locations, 2018 [Internet]. American Society of Anesthesiologists; [updated 2018 Oct 17]. Available at: https://www.asahq.org/standards-and-guidelines/statement-on-nonoperating-room-anesthetizing-locations . [Accessed 21 May 2021]
Walls JD, Weiss MS. Safety in nonoperating room anesthesia (NORA). APSF Newslett 2019; 34:3–4.
Nagrebetsky A, Gabriel RA, Dutton RP, Urman RD. Growth of nonoperating room anesthesia care in the United States: a contemporary trends analysis. Anesth Analg 2017; 124:1261–1267.
Smith RA, Manassaram-Baptiste D, Brooks D, Doroshenk M, et al. Cancer screening in the United States, 2015: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 2015; 65:30–54.
Wolf AMD, Fontham ETH, Church TR, Flowers CR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin 2018; 68:250–281.
Chang B, Kaye AD, Diaz JH, Westlake B, et al. Interventional procedures outside of the operating room: results from the National Anesthesia Clinical Outcomes Registry. J Patient Saf 2018; 14:9–16.
Cheney FW, Warner DS. The American Society of Anesthesiologists Closed Claims Project. Anesthesiology 2010; 113:957–960.
Woodward ZG, Urman RD, Domino KB. Safety of non–operating room anesthesia. Anesthesiol Clin 2017; 35:569–581.
Metzner J, Posner KL, Domino KB. The risk and safety of anesthesia at remote locations: the US closed claims analysis. Curr Opin Anaesthesiol 2009; 22:502–508.
Kotob F, Twersky RS. Anesthesia outside the operating room: general overview and monitoring standards. Int Anesthesiol Clin 2003; 41:1–15.
Choi JW, Kim DK, Lee SH, Shin HS, et al. Comparison of safety profiles between nonoperating room anesthesia and operating room anesthesia: a study of 199,764 cases at a Korean Tertiary Hospital. J Korean Med Sci 2018; 33:183–193.
Bhavani S. Non-operating room anesthesia in the endoscopy unit. Gastrointest Endosc Clin N Am 2016; 26:471–483.
Adams MA, Prenovost KM, Dominitz JA, Kerr EA, et al. National trends in use of monitored anesthesia care for outpatient gastrointestinal endoscopy in the veterans health administration. JAMA Intern Med 2017; 177:436–438.
Agrawal D, Rockey DC. Propofol for screening colonoscopy in low-risk patients. JAMA Intern Med 2013; 173:1836–1838.
Leung FW. Trends in use of sedation for low-risk endoscopy. JAMA 2017; 317:2006–2007.
Vargo JJ, Niklewski PJ, Williams JL, Martin JF, et al. Patient safety during sedation by anesthesia professionals during routine upper endoscopy and colonoscopy: an analysis of 1.38 million procedures. Gastrointest Endosc 2017; 85:101–108.
Wernli KJ, Brenner AT, Rutter CM, Inadomi JM. Risks associated with anesthesia services during colonoscopy. Gastroenterology 2016; 150:888–894.
Gotoda T, Okada H, Hori K, Kawahara Y, et al. Propofol sedation with a target-controlled infusion pump and bispectral index monitoring system in elderly patients during a complex upper endoscopy procedure. Gastrointest Endosc 2016; 83:756–764.
Galeazzi M, Mazzola P, Valcarcel B, Bellelli G, et al. Endoscopic retrograde cholangiopancreatography in the elderly: results of a retrospective study and a geriatricians’ point of view. BMC Gastroenterol 2018; 18:38.
Stone AB, Brovman EY, Greenberg P, Urman RD. A medicolegal analysis of malpractice claims involving anesthesiologists in the gastrointestinal endoscopy suite. J Clin Anesth 2018; 48:15–20.
American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Practice guidelines for moderate procedural sedation and analgesia. Anesthesiology 2018; 128:437–479.
Urman RD, Moucharite M, Flynn C, Nuryyeva E, et al. Impact of respiratory compromise in inpatient interventional radiology procedures with moderate sedation in the United States. Radiology 2019; 292:702–710.
Holzwanger DJ, Madoff DC. Role of interventional radiology in the management of hepatocellular carcinoma: current status. Chin Clin Oncol 2018; 7:49.
Amin A, Lane JS. The future of anesthesia for interventional radiology. Curr Opin Anesthesiol 2018; 31:469–472.
Nicoara A, Holmquist F, Raggains C, Mathew JP. Anesthesia for catheter ablation procedures. J Cardiothorac Vasc Anesth 2014; 28:1589–1603.
Neuburger PJ, Patel PA. Anesthetic techniques in transcatheter aortic valve replacement and the evolving role of the anesthesiologist. J Cardiothorac Vasc Anesth 2017; 31:2175–2182.
Babaliaros V, Devireddy C, Lerakis S, Leonardi R, et al. Comparison of transfemoral transcatheter aortic valve replacement performed in the catheterization laboratory (Minimalist Approach) versus hybrid operating room (Standard Approach). JACC: Cardiovasc Interv 2014; 7:898–904.
Braithwaite S, Kluin J, Buhre WF, de Waal EEC. Anaesthesia in the cardiac catheterization laboratory. Curr Opin Anaesthesiol 2010; 23:507–512.
Lee DW, Wasowicz M. Recent advances in nonoperating room anesthesia for cardiac procedures. Curr Opin Anaesthesiol 2020; 33:601–607.
Nelson EW, Woltz EM, Wolf BJ, Gold MR. A survey of current anesthesia trends for electrophysiology procedures. Anesth Analg 2018; 127:46–53.
O’Byrne ML, Kennedy KF, Steven JM, Hill KD, et al. Outcomes of operator-directed sedation and anesthesiologist care in the pediatric/congenital catheterization laboratory: a study utilizing data from the IMPACT Registry. Cardiovasc Interv 2021; 14:401–413.
Bergeron M, Lee DR, Demarcantonio MA, Kandil A, et al. Safety and cost of drug-induced sleep endoscopy outside the operating room. Laryngoscope 2020; 130:2076–2080.
Ghazizadeh S, Moore K, Kiai K, Mendelsohn AH. Drug-induced sleep endoscopy performed in the endoscopy suite: a resource utilization analysis. Otolaryngol Head Neck Surg 2020; 162:386–391.
Rodrigues FB, Neves JB, Caldeira D, Ferro JM, et al. Endovascular treatment versus medical care alone for ischaemic stroke: systematic review and meta-analysis. BMJ 2016; 353:i1754.
Wijayatilake DS, Ratnayake G, Ragavan D. Anaesthesia for neuroradiology: thrombectomy: ‘one small step for man, one giant leap for anaesthesia’. Curr Opin Anesthesiol 2016; 29:568–575.
Pöyhiä R. Nonoperating room anesthesia for patients with serious comorbidities. Curr Opin Anesthesiol 2020; 33:534–600.
Sultan S, Lim JK, Altayar O, Davitkov P, et al. AGA rapid recommendations for gastrointestinal procedures during the COVID-19 pandemic. Gastroenterology 2020; 159:739–758. e4.
Wahidi MM, Shojaee S, Lamb CR, Ost D, et al. The use of bronchoscopy during the coronavirus disease 2019 pandemic: CHEST/AABIP guideline and expert panel report. Chest 2020; 158:1268–1281.
Anca D, Pua B, Mack PF. NORA: considerations during COVID 19 pandemic–The New York Experience. Perioper Care Oper Room Manag 2021; 22:100148.
Abadal JM, Gonzalez-Nieto J, Lopez-Zarraga F, Angel De Gregorio M, et al. Future scenarios and opportunities for interventional radiology in the post COVID-19 era. Diagn Interv Radiol 2021; 27:263–268.
Centers for Disease Control and Prevention. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Regulated Medical Waste, Guidelines for Environmental Infection Control in Health Care Facilities [Internet]. Atlanta (GA): Centers for Disease Prevention and Control; [updated 2019 Jul]. Available at: https://www.cdc.gov/infectioncontrol/guidelines/environmental/index.html . [Accessed 22 May 2021]