Non-Operating Room Anesthesia (NORA) is a relatively new classification for the spectrum of anesthesia cases that occurs outside the traditional Operating Room suite.
NORA cases often happen in a location that is physically distant from the majority, or even entirety, of a medical facility’s surgical cases. A major implication is that available backup assistance of anesthesia staff, other essential support personnel, specialized rescue equipment, and drugs may be separated from these cases by significant travel time. For example, our outpatient ECT Center at Vista is a ten mile drive from the hospital campus, and North Tower IR suites are two floors away from the Main OR and anesthesia workroom. At other times NORA can be located in a separate area that remains closely integrated with the main OR via doors and/or hallways (like our South Tower GI Endoscopy and IR rooms).
NORA represents an ever-growing percentage of surgical and procedural volume, which makes an understanding of its current and future characteristics and trends advisable for all anesthesiologists.
Surgeries & Procedures
- GI Endoscopy
- Interventional Radiology
- Interventional Cardiology
- Office-based Plastic Surgery
- Office-based Dental Surgery
By graduation, the anesthesiology resident will have sufficient experience with each of these services to have a working knowledge of the requirements for independently delivering safe, efficient, quality anesthesia for the diverse patient population presenting for NORA. (We currently do not staff anesthesia for private offices, yet there are ample resident opportunities to provide anesthesia for plastic surgery and dental surgery cases at FSC and North Tower.)
NORA patients run the gamut of ASA 1- ASA 4, whether they arrive as outpatients or inpatients. Their preoperative preparation can range from none to poor to excellent.
The anesthesiology resident must learn to locate and synthesize pertinent notes, consultations, and laboratory data; and then apply skill, knowledge, communication, and professionalism to navigate NORA scenarios in keeping with the tenets of the Core Competencies for anesthesiology residency.
Skill, familiarity, and organizational expertise in the NORA realm are key assets worth acquiring for individual success in both private practice and academic anesthesia settings. NORA case numbers and procedural complexity are destined to continue their rapid growth.
- Acute Pain
- Ambulatory Anesthesia
- Cardiothoracic Anesthesiology
- Congential Heart Anesthesiology
- Critical Care Medicine
- Liver & Transplant Anesthesiology
- Multispecialty Anesthesia
- Non-OR Anesthesia
- Obstetric Anesthesiology
- Pain Medicine
- Pediatric Anesthesiology
- Perioperative Cognitive Anesthesia Network
- Perioperative Medicine
- Vascular Anesthesia