Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine, The University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Curr Opin Anaesthesiol. 2020 Aug;33(4):584-588. doi: 10.1097/ACO.0000000000000880.
Nonoperating room anesthesia (NORA) cases performed in pediatric patients have increased over the past decade. It is imperative for the anesthesia provider to be familiar with the nuances of this environment and the myriad of cases to ensure delivery of safe and efficient care.
Though case volume has increased, sedative agents have largely remained unchanged. NORA sites must meet the same operating room standards and expectations of anesthesia established by the American Society of Anesthesiologists. Despite the increasing NORA volume and efforts to instill a similar culture of safety as the operating room complex, NORA cases present challenges with limited resources and access to the patient, highlighting the need for resident and fellow training to include NORA experiences.
Experience working in the NORA environment helps provide, maintain, and improve the cognitive fitness and resilience that an anesthesiologist needs to tackle the complexities from the variety of NORA cases and locations. Patient factors aside, procedural considerations can affect the anesthetic plan, so understanding the nuances of the procedure helps the anesthesia provider provide safe and efficient care.
在过去十年中，儿科患者的非手术室麻醉（NORA）案例有所增加。麻醉提供者必须熟悉这一环境的细微差别和众多案例，以确保提供安全有效的护理。
尽管案例数量有所增加，但镇静剂在很大程度上保持不变。NORA 地点必须符合美国麻醉师协会制定的相同手术室标准和麻醉期望。尽管 NORA 数量不断增加，并努力灌输与手术室一样的安全文化，但 NORA 案例面临着资源有限和难以接触患者的挑战，这突出表明需要对住院医师和研究员进行培训，包括 NORA 经验。
在 NORA 环境中工作的经验有助于提供、维持和提高麻醉师应对各种 NORA 案例和地点复杂性所需的认知能力和适应能力。除了患者因素外，程序考虑因素也会影响麻醉计划，因此了解程序的细微差别有助于麻醉提供者提供安全有效的护理。
