Features  |   November 2019
Non-Operating Room Anesthesia: Educator and Learner Perspectives
Author Affiliations
  • Sandeep Khanna, M.D.
    Abstract Review Subcommittee on Perioperative Medicine
Article Information
Education / CPD / Patient Safety / Respiratory System / Features
Features   |   November 2019
Non-Operating Room Anesthesia: Educator and Learner Perspectives
ASA Monitor 11 2019, Vol.83, 14-17.
ASA Monitor 11 2019, Vol.83, 14-17.
The need for anesthesia services in offsite locations has increased rapidly over the last decade, creating numerous challenges for the busy anesthesiologist. With evolving technology, less invasive procedures have emerged as an alternative to traditional surgical approaches. The sheer volume of cases in offsite locations has been steadily increasing and generating substantial revenue for hospitals, necessitating the creation of a reliable and safe non-operating room anesthesia (NORA) service. Creation of such a service has required anticipating current and future needs driven by changes in patient demographics, financial reimbursement models and prioritization of patient safety.
Nagrebetsky et al. retrospectively analyzed data from the National Anesthesia Clinical Outcomes Registry (NACOR) to examine trends and characteristics of NORA and O.R. cases during a four-year period spanning from 2010 to 2014. This registry captures data from approximately 25 percent of all anesthetics in the United States. NORA cases constituted a third of the 18 million cases analyzed. Additionally, patients presenting for NORA procedures were older, were more likely to be ASA Physical Status III-V and more often underwent procedural intervention after normal working hours compared to traditional O.R. patients. Two thirds of patients presenting for NORA were older than 50 years and half of these were elderly (>65 years of age).1 
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