Non-operating Room Anesthesia Services From a Tertiary Specialized Center in Saudi Arabia: An Overview With Literature Review

Abstract

Introduction Non-operating room anesthesia (NORA) is rapidly expanding as it provides a less invasive option to the conventional operating room (OR), yet increases the efficiency and reduces the burden of OR resources. It is frequently used in well-equipped rooms in areas such as cardiology, radiology, and endoscopy, allowing patients to be treated efficiently. Nonetheless, with the complexity of cases and the challenges of the non-OR environment, NORA cases have higher risks of morbidity and mortality, highlighting the need for standardized protocols, special training, and safety measures to mitigate such risks. Methodology The data were obtained from the IT department at King Abdullah Specialist Children Hospital, Ministry of National Guard Health Affairs (MNGHA), on NORA cases from 2023 and 2024. Databases such as PubMed, Scopus, Web of Science, and Google Scholar were used to conduct the literature review. The inclusion criteria involved non-OR procedures in a tertiary hospital and studies published from 2000 to 2025. OR-based anesthesia, studies conducted outside of the timeframe, and non-indexed and non-English research were excluded. Data and descriptive analysis By assigning specified time periods for procedures, we developed an organizational strategy-based NORA system that enhanced scheduling and service delivery while lowering cancellations. This strategy ensures improved resource use, increases efficiency, and prevents emergency services from being misused. Although NORA cases have increased overall, indicating rising demands, the variation in the service trends points to the need for additional research to maximize resource allocation and meet changing patient needs. Conclusion NORA is increasingly becoming an essential asset within healthcare services, facilitating improved efficiency and better patient outcomes. However, to achieve more resourceful utilization of NORA, improvements in scheduling and service delivery must be implemented at an institutional systemic level. Our study demonstrated that implementing an efficient scheduling system in NORA services can lead to significant improvements in healthcare provision. However, many challenges still impede the effective implementation of NORA, and a continued review of data and patient feedback is essential.

Keywords: adverse events; anesthetic services; healthcare systems; non-operating room anesthesia; patient safety; scheduling efficiency.