Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Aug 1;35(4):493-501.
doi: 10.1097/ACO.0000000000001158. Epub 2022 Jul 5.

Prevention of pulmonary complications in sedated patients undergoing interventional procedures in the nonoperating room anesthesia setting

Felipe Urdaneta  1 , Richa Wardhan, Gregory Wells, Jeffrey D White
Affiliations
Review

Prevention of pulmonary complications in sedated patients undergoing interventional procedures in the nonoperating room anesthesia setting

Felipe Urdaneta et al. Curr Opin Anaesthesiol. .

Abstract

Purpose of review: Nonoperating room anesthesia (NORA) procedures have expanded in number, variety, and complexity. NORA involves all age groups, including frail older adults and patients often considered too sick to tolerate traditional surgical interventions. Postoperative pulmonary complications are a significant source of adverse events in the perioperative setting. We present a review focused on preventing pulmonary complications in the interventional NORA setting.

Recent findings: NORA locations should function as independent, autonomous ambulatory units. We discuss a strategic plan involving a thorough preoperative evaluation of patients, including recognizing high-risk patients and their anesthetic management. Finally, we offer guidance on the challenges of conducting sedation and anesthesia in patients with coronavirus disease 2019 (COVID-19) or a history of COVID-19.

Summary: The demands on the interventional NORA anesthesia team are increasing. Strategic planning, checklists, consistent staffing assignments, and scheduled safety drills are valuable tools to improve patient safety. In addition, through quality improvement initiatives and reporting, NORA anesthetists can achieve reductions in periprocedural pulmonary complications.

PubMed Disclaimer

References

    1. Chang B, Kaye AD, Diaz JH, et al. Interventional procedures outside of the operating room: results from the National Anesthesia Clinical Outcomes Registry. J Patient Saf 2018; 14:9–16.
    1. Du AL, Robbins K, Waterman RS, et al. National trends in nonoperating room anesthesia: procedures, facilities, and patient characteristics. Curr Opin Anaesthesiol 2021; 34:464–469.
    1. 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.
    1. Grewal G, Joshi GP. Obesity and obstructive sleep apnea in the ambulatory patient. Anesthesiol Clin 2019; 37:215–224.
    1. Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth 2017; 118:317–334.