Research Article
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Year 2024, Volume: 15 Issue: 53, 130 - 136, 05.12.2024
https://doi.org/10.17944/interdiscip.1517431

Abstract

References

  • Metzner J, Domino KB. Risks of anesthesia or sedation outside the operating room: the role of the anesthesia care provider. Curr Opin Anaesthesiol. 2010;23:523-31. https://doi.org/10.1097/ACO.0b013e32833b7d7c
  • Turkish Society of Anesthesiology and Reanimation (TARD). Guidelines for Non-Operating Room Anesthesia Applications, March 2022. Available at: https://akademi.tard.org.tr
  • 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(4):1261-7. https://doi.org/10.1213/ANE.0000000000001734
  • Borshoff DC, Sadleir P. Nonoperating room anaesthesia: safety, monitoring, cognitive aids and severe acute respiratory syndrome coronavirus 2. Curr Opin Anaesthesiol. 2020;33(4):554-60. https://doi.org/10.1097/ACO.0000000000000895
  • Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J. 1974;2(5920):656-9. https://doi.org/10.1136/bmj.2.5920.656
  • Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89-91. https://doi.org/10.1016/0952-8180(94)00001-K
  • Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB et al. Conventional versus analgesia-oriented combination sedation on recovery profiles and satisfaction after ERCP: A randomized trial. PLoS ONE 2015;24:10(9): e0138422.
  • Cousins MJ. Monitoring-the anaesthetist’s view. Scand J Gastroenterol Suppl volume 25 1990;179:12-7. https://doi.org/10.3109/00365529009093166
  • Chang B, Urman RD. Nonoperating room anesthesia: The principles of patient assessment and preparation. Anesthesiol Clin 2016;34:223-40. https://doi.org/10.1016/j.anclin.2015.10.017
  • Walls JD, Weiss MS. Safety in non-operating room anesthesia (NORA)vol. 34. Anesthesia Patient Safety Foundation; 2019. p.3. Available from: https://www.apsf.org/article/safety-in-non-operating-room-anesthesia-nora/. [Accessed June 30,2021].
  • Karamnov S, Sarkisian N, Grammer R, Gross WL, Urman RD. Analysis of Adverse Events Associated With Adult Moderate Procedural Sedation Outside the Operating Room. J Patient Saf. 2017;13(3):111-21. https://doi.org/10.1097/PTS.0000000000000135
  • Chang B, Kaye AD, Diaz JH, Westlake B, Dutton RP, Urman RD. Interventional Procedures Outside of the Operating Room: Results From the National Anesthesia Clinical Outcomes Registry. J Patient Saf. 2018;14(1):9-16. https://doi.org/10.1097/PTS.0000000000000156
  • Iyilikci L, Çakmak S, Ögdül E. Our experience in non-operating room anesthesia. Türk Anest Rean Der Dergisi 2006;34:169-76.
  • Turan, A. Z., Yılmaz, M., Aydaş, A. D., Gurbuz Aytuluk, H., Şimşek, T., & Saracoglu, K. T. Gastrointestinal endoskopik girişimlerde uygulanan sedasyon uygulamalarının retrospektif değerlendirilmesi. Kocaeli Tıp Dergisi 2020;9(1):152-9.
  • Wong T, Georgiadis PL, Urman RD, Tsai MH. Non-Operating Room Anesthesia: Patient Selection and Special Considerations. Local Reg Anesth. 2020;13:1-9. https://doi.org/10.2147/LRA.S181458
  • Çeğin MB, Soyoral L, Yüzkat N, Kılıç M, Kurt N, Göktaş U Ameliyathane dışı anestezi uygulamalarımız: 528 hastanın değerlendirilmesi. Journal of Clinical and Experimental Investigations 2015;6(2):150-3.
  • Cooka T, Cordes Behringer E, Benger J. Airway management outside the operating room: Hazardous and incompletely studied. Curr Opin Anaesthesiol. 2012;25:461-9. https://doi.org/10.1097/ACO.0b013e32835528b1
  • Hu Y, Xu W, Cao F. A meta-analysis of randomized controlled trials: combination of ketamine and propofol versus ketamine alone for procedural sedation and analgesia in children. Intern Emerg Med. 2019;14(7):1159-65. doi: 10.1007/s11739-019-02173-6.
  • Mason KP, Roback MG, Chrisp D, Sturzenbaum N, Freeman L, Gozal D, Vellani F, Cavanaugh D, Green SM. Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters. J Clin Med. 2019;8(12):2087. doi: 10.3390/jcm8122087.
  • Metzner J, Posner KL, Domino KB. The risk and safety of anesthesia at remote locations: the US closed claims analysis. Curr Opin Anaesthesiol. 2009;22:502-8. https://doi.org/10.1097/ACO.0b013e32832dba50
  • Amornyotin S. Sedation-related complications in gastrointestinal endoscopy. World J Gastrointest Endosc. 2013;5:527-33. https://doi.org/10.4253/wjge.v5.i11.527
  • Melloni C. Anesthesia and sedation outside the operating room: how to prevent risk and maintain good quality. Curr Opin Anaesthesiol. 2007;20:513-9. https://doi.org/10.1097/ACO.0b013e3282f06ba6.

A Retrospective Analysis of Non-Operating Room Anesthesia Practices at University Hospital

Year 2024, Volume: 15 Issue: 53, 130 - 136, 05.12.2024
https://doi.org/10.17944/interdiscip.1517431

Abstract

Abstract:
Objective: The use of non-operating room anesthesia (NORA) is increasing due to its advantages in procedure success and patient management. This study aims to retrospectively evaluate the NORA practices at Hatay Mustafa Kemal University hospital over a two-year period.
Materials and Methods: After obtaining ethical approval, the records of patients who underwent sedation-analgesia outside the operating room for diagnostic and therapeutic purposes between 2018 and 2020 were retrospectively analyzed. Recorded data included age, gender, weight, American Society of Anesthesiologists (ASA) physical status classification, comorbidities, types of procedures, anesthesia and recovery times, medications used, and complications.
Results: A total of 1199 patients were included in the study, with 63.3% (759) adults and 36.7% (440) pediatric patients. The patient group comprised 69.1% (829) female and 30.9% (370) male, with a mean age of 35.62 ± 28.69 years (0-98). Of the patients, 46.1% (547) were in the ASA 2 risk group. The most common procedure was Magnetic Resonance Imaging (MRI) 45.1% (541). The most frequently used anesthetic regimen was a combination of midazolam, propofol, and ketamine 70.1% (840). Hypotension was the most common complication 3.7% (44), followed by bradycardia 3.2% (38). Hypertension was the most frequently (12.0%) observed comorbidity.
Conclusion: The frequency of non-operating room anesthesia (NORA) procedures is steadily increasing due to growing patient and surgeon satisfaction. Comprehensive preanesthetic evaluations, ensuring appropriate physical conditions and patient-specific drug selection are crucial for appropriate and rapid interventions for possible complications.
Keywords: Non-operating room anesthesia practices, Pre-anesthetic evaluation, Sedation, Anesthetic agents, Complications

References

  • Metzner J, Domino KB. Risks of anesthesia or sedation outside the operating room: the role of the anesthesia care provider. Curr Opin Anaesthesiol. 2010;23:523-31. https://doi.org/10.1097/ACO.0b013e32833b7d7c
  • Turkish Society of Anesthesiology and Reanimation (TARD). Guidelines for Non-Operating Room Anesthesia Applications, March 2022. Available at: https://akademi.tard.org.tr
  • 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(4):1261-7. https://doi.org/10.1213/ANE.0000000000001734
  • Borshoff DC, Sadleir P. Nonoperating room anaesthesia: safety, monitoring, cognitive aids and severe acute respiratory syndrome coronavirus 2. Curr Opin Anaesthesiol. 2020;33(4):554-60. https://doi.org/10.1097/ACO.0000000000000895
  • Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J. 1974;2(5920):656-9. https://doi.org/10.1136/bmj.2.5920.656
  • Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995;7(1):89-91. https://doi.org/10.1016/0952-8180(94)00001-K
  • Shin S, Oh TG, Chung MJ, Park JY, Park SW, Chung JB et al. Conventional versus analgesia-oriented combination sedation on recovery profiles and satisfaction after ERCP: A randomized trial. PLoS ONE 2015;24:10(9): e0138422.
  • Cousins MJ. Monitoring-the anaesthetist’s view. Scand J Gastroenterol Suppl volume 25 1990;179:12-7. https://doi.org/10.3109/00365529009093166
  • Chang B, Urman RD. Nonoperating room anesthesia: The principles of patient assessment and preparation. Anesthesiol Clin 2016;34:223-40. https://doi.org/10.1016/j.anclin.2015.10.017
  • Walls JD, Weiss MS. Safety in non-operating room anesthesia (NORA)vol. 34. Anesthesia Patient Safety Foundation; 2019. p.3. Available from: https://www.apsf.org/article/safety-in-non-operating-room-anesthesia-nora/. [Accessed June 30,2021].
  • Karamnov S, Sarkisian N, Grammer R, Gross WL, Urman RD. Analysis of Adverse Events Associated With Adult Moderate Procedural Sedation Outside the Operating Room. J Patient Saf. 2017;13(3):111-21. https://doi.org/10.1097/PTS.0000000000000135
  • Chang B, Kaye AD, Diaz JH, Westlake B, Dutton RP, Urman RD. Interventional Procedures Outside of the Operating Room: Results From the National Anesthesia Clinical Outcomes Registry. J Patient Saf. 2018;14(1):9-16. https://doi.org/10.1097/PTS.0000000000000156
  • Iyilikci L, Çakmak S, Ögdül E. Our experience in non-operating room anesthesia. Türk Anest Rean Der Dergisi 2006;34:169-76.
  • Turan, A. Z., Yılmaz, M., Aydaş, A. D., Gurbuz Aytuluk, H., Şimşek, T., & Saracoglu, K. T. Gastrointestinal endoskopik girişimlerde uygulanan sedasyon uygulamalarının retrospektif değerlendirilmesi. Kocaeli Tıp Dergisi 2020;9(1):152-9.
  • Wong T, Georgiadis PL, Urman RD, Tsai MH. Non-Operating Room Anesthesia: Patient Selection and Special Considerations. Local Reg Anesth. 2020;13:1-9. https://doi.org/10.2147/LRA.S181458
  • Çeğin MB, Soyoral L, Yüzkat N, Kılıç M, Kurt N, Göktaş U Ameliyathane dışı anestezi uygulamalarımız: 528 hastanın değerlendirilmesi. Journal of Clinical and Experimental Investigations 2015;6(2):150-3.
  • Cooka T, Cordes Behringer E, Benger J. Airway management outside the operating room: Hazardous and incompletely studied. Curr Opin Anaesthesiol. 2012;25:461-9. https://doi.org/10.1097/ACO.0b013e32835528b1
  • Hu Y, Xu W, Cao F. A meta-analysis of randomized controlled trials: combination of ketamine and propofol versus ketamine alone for procedural sedation and analgesia in children. Intern Emerg Med. 2019;14(7):1159-65. doi: 10.1007/s11739-019-02173-6.
  • Mason KP, Roback MG, Chrisp D, Sturzenbaum N, Freeman L, Gozal D, Vellani F, Cavanaugh D, Green SM. Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters. J Clin Med. 2019;8(12):2087. doi: 10.3390/jcm8122087.
  • Metzner J, Posner KL, Domino KB. The risk and safety of anesthesia at remote locations: the US closed claims analysis. Curr Opin Anaesthesiol. 2009;22:502-8. https://doi.org/10.1097/ACO.0b013e32832dba50
  • Amornyotin S. Sedation-related complications in gastrointestinal endoscopy. World J Gastrointest Endosc. 2013;5:527-33. https://doi.org/10.4253/wjge.v5.i11.527
  • Melloni C. Anesthesia and sedation outside the operating room: how to prevent risk and maintain good quality. Curr Opin Anaesthesiol. 2007;20:513-9. https://doi.org/10.1097/ACO.0b013e3282f06ba6.
There are 22 citations in total.

Details

Primary Language English
Subjects Surgery (Other)
Journal Section Research Articles
Authors

Senem Urfalı 0000-0003-4500-2408

Mehmet Murat Çelik 0000-0002-8164-1322

Mehmet Karadağ 0000-0001-9539-4193

Mehmet Çömez 0000-0003-0821-5148

Buket Akkurt 0000-0001-9937-6865

Onur Koyuncu 0000-0002-0282-181X

Publication Date December 5, 2024
Submission Date July 16, 2024
Acceptance Date November 7, 2024
Published in Issue Year 2024 Volume: 15 Issue: 53

Cite

Vancouver Urfalı S, Çelik MM, Karadağ M, Çömez M, Akkurt B, Koyuncu O. A Retrospective Analysis of Non-Operating Room Anesthesia Practices at University Hospital. Interdiscip Med J. 2024;15(53):130-6.