Nonoperating room anesthesia in different parts of the world

Abstract

Purpose of review Advances in early diagnosis and treatment of diseases using minimally invasive procedures has led to an increase in the number of cases in locations outside the operating room. This surge created the need for anesthesia services to expand to these areas to provide well tolerated and favorable procedural conditions. The present review describes nonoperating room anesthesia patterns in different parts of the world. Recent findings Nonoperating room anesthesia has grown exponentially over the last years. Patients scheduled in these areas are sicker and older compared to the operating room patients. Anesthesiologist-directed care has proven to be well tolerated, with less serious complications and improvement in patients and proceduralist satisfaction. Summary There are marked variations in how anesthesia services are delivered in out of operating room locations in different parts of the world. Although there are some data available from the United States, expansion of minimally invasive procedures across continents will likely lead to the emergence of various models of delivering anesthetic care.

Comparison of 95% effective dose of remimazolam besylate and propofol for gastroscopy sedation on older patients: A single‐centre randomized controlled trial

“…Patients presenting for gastroscopy are increasingly older and more frail 2 . Recently, remimazolam has been thought to be a new promising sedative for procedural sedation.…”

“…Patients presenting for gastroscopy are increasingly older and more frail. 2 Recently, remimazolam has been thought to be a new promising sedative for procedural sedation. In this trial, we found that combined with 0.2 μg/kg remifentanil, the ED95 induction dose to inhibiting movements of older patients undergoing gastroscopy was 0.2039 (95%CI 0.1753-0.3896) mg/kg for remimazolam besylate and 1.9944 (95%CI 1.7386-5.9553) mg/kg for propofol.…”

“…The predicted number would reach 35 million by 2030, according to the growth rate of aging 1 . Today, the use of sedation in gastroscopy has exponentially increased globally, 1,2 because it can help patients tolerate unpleasant or painful procedures and avoid potentially unwanted memories. It also increases the likelihood of successful procedures and detection of superficial gastrointestinal lesions, 3 thus realizing a high‐quality process of gastroscopic diagnosis and treatment.…”

Satisfacción de pacientes en servicio de anestesia fuera de quirófano. Aplicación Escala ISAS

“…El 80,4% fue ASA II y ASA III con una edad promedio de 56 años, y con una población mayor a 70 años del 26,8%. Hallazgos que pudieran ser similares a los reportados [6], [8], [9], [10]. En la revisión de Kim et al, se encontró que la edad mayor a 70 años era el 20% en AFQ frente al 12% en salas de cirugía y el 69% de los casos de AFQ estaban en las categorías III-V de ASA frente a 44% para casos de quirófano [8].…”

Anesthesia Patient Safety: Next Steps to Improve Worldwide Perioperative Safety by 2030

“…77,78 Allocation of Safety Research and Resources to Nonoperating Room Anesthesia Practices In many high-income countries, there is significant growth in numbers of surgical, interventional, and diagnostic procedures for which patients require anesthesia care performed in nonoperating room environments. 79,80 The provision of anesthesia services in these unique and often variable settings raises potential safety barriers related to interprofessional communications, infrastructure, and safety cultures. 81,82 As noted in a number of the summaries in this article, national anesthesiology societies are very interested in learning how to best address these potential barriers, ensure that standards of care are followed, and develop outcome reporting databases to track patient safety and, when appropriate, develop and implement patient care processes to improve safety.…”