Patient monitoring in the nonoperating room anesthesia (NORA) setting: current advances in technology

Abstract

Purpose of reviewNonoperating room anesthesia (NORA) procedures continue to increase in type and complexity as procedural medicine makes technical advances. Patients presenting for NORA procedures are also older and sicker than ever. Commensurate with the requirements of procedural medicine, anesthetic monitoring must meet the American Society of Anesthesiologists standards for basic monitoring. Recent findingsThere have been improvements in the required monitors that are used for intraoperative patient care. Some of these changes have been with new technologies and others have occurred with software refinements. In addition, specialized monitoring devises have also been introduced into NORA locations (depth of hypnosis, respiratory monitoring, point-of care ultrasound). These additions to the monitoring tools available to the anesthesiologist working in the NORA-environment push the boundaries of procedures which may be accomplished in this setting. SummaryNORA procedures constitute a growing percentage of total administered anesthetics. There is no difference in the monitoring standard between that of an anesthetic administered in an operating room and a NORA location. Anesthesiologists in the NORA setting must have the same compendium of monitors available as do their colleagues working in the operating suite.

Patient selection for nonoperating room anesthesia

“…In some cases, providers and patients may not even be in the same room. Although novel monitoring systems may assist providers, vigilance remains paramount [16,17]. Combining ergonomic limitations with sicker patients, it is no surprise that Schroeck et al [18 && ] found that NORA anesthesia providers report higher stress, workload, and anxiety.…”