Royz Isabel E, Clevenger Nicholas B, Bochenek Andrew, Locke Andrew R, Greenberg Steven B
Department of Anesthesiology, Critical Care, and Pain Medicine, Endeavor Health, Evanston, IL 60201, USA.
Department of Anesthesiology and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.
J Clin Med. 2025 Jun 26;14(13):4528. doi: 10.3390/jcm14134528.
Non-operating room anesthesia (NORA) is a rapidly growing domain for anesthesia professionals due to advances in procedural technology and increased emphasis on patient comfort. The majority of these procedures are conducted under monitored anesthesia care (MAC) where patients receive varying levels of sedation. Analysis of the Anesthesia Closed Claims database suggests that adverse respiratory events continue to be the main cause of morbidity and mortality in patients undergoing NORA procedures. Most NORA claims occurred under MAC, with oversedation leading to respiratory depression coupled with inadequate monitoring making up the majority of claims. The American Society of Anesthesiologists (ASA) has released standards of pre-anesthesia, intraoperative monitoring, and post-anesthesia care, which apply to all anesthetizing locations including NORA. The ASA has also made recommendations in a statement on NORA to promote patient safety. Evidence suggests that patient characteristics, monitoring tools, physical constraints, and team familiarity play a role in the risk for adverse respiratory events. Future studies are required to further understand the challenges specific to NORA locations.
由于手术技术的进步以及对患者舒适度的日益重视，非手术室麻醉（NORA）对于麻醉专业人员来说是一个快速发展的领域。这些手术大多在监护麻醉（MAC）下进行，患者会接受不同程度的镇静。对麻醉闭合性索赔数据库的分析表明，不良呼吸事件仍然是接受NORA手术患者发病和死亡的主要原因。大多数NORA索赔发生在MAC下，过度镇静导致呼吸抑制，加上监测不足，构成了大多数索赔原因。美国麻醉医师协会（ASA）发布了麻醉前、术中监测和麻醉后护理标准，这些标准适用于包括NORA在内的所有麻醉场所。ASA还在一份关于NORA的声明中提出了建议，以促进患者安全。有证据表明，患者特征、监测工具、身体限制和团队熟悉程度在不良呼吸事件风险中起作用。需要进一步的研究来深入了解NORA场所特有的挑战。
