Sedation technique considerations for nonoperating room anesthesia: a narrative review and update

Area of Science:

• Anesthesiology
• Patient Safety
• Procedural Sedation

Background:

• Nonoperating room anesthesia (NORA) is increasingly common for procedures outside traditional operating rooms.
• Diverse settings present unique challenges in monitoring, equipment, and emergency response.
• Adapting sedation practices is crucial for patient comfort and cooperation.

Purpose of the Study:

• To review current sedation techniques for nonoperating room anesthesia (NORA).
• To highlight the importance of adapting sedation practices to diverse procedural environments.
• To emphasize the need for maintaining high safety and efficacy standards in NORA.

Main Methods:

• Review of common sedation techniques (moderate, deep sedation, general anesthesia).
• Discussion of frequently used anesthetic agents (propofol, dexmedetomidine, fentanyl, midazolam).
• Emphasis on balanced sedation approaches.

Main Results:

• Sedation technique choice is guided by procedure, patient status, and available resources.
• Commonly used agents offer rapid onset, short half-lives, and predictable pharmacokinetics.
• Balanced sedation combines agents to minimize side effects and optimize sedation levels.

Conclusions:

• NORA practices must meet operating room standards, including ASA monitoring.
• Portable monitoring and robust emergency preparedness are essential for NORA.
• Tailored protocols and refined safety standards are vital as NORA cases increase.