Our Non-Operating Room Anesthesia Experiences

Aim: In this study, we aimed to discuss our experience and results of non-operating room anesthesia.

Materials and Methods: Anesthesia records of patients older than 18 years who underwent sedo-analgesia outside the operating room for diagnosis and treatment between May 2017 and December 2017 were retrospectively screened. The records were examined in terms of demographic data, applied procedure, duration of the procedure, sedation grade, medications used, developing minor and major complications, chronic obstructive pulmonary disease story and intensive care need. Relationships between complications with demographic data and categorical variables were analyzed.

Results: Totally 2562 patients underwent sedo-analgesia. 1428 (55.7%) of these cases were female and 1134 (44.3%) of them were male. The average age of patients was 53.08±16.55. 268 (10.5%) of the cases were ASA I, 1683 (65.7%) were ASA II, 598 (23.3%) were ASA III and 13 (0.5%) were ASA IV. 519 (20.3%) patients were minimally sedated, 1541 (60.1%) were moderate sedated and 502 (19.6%) deep sedated. The longest procedure time in endoscopic retrograde cholangiopancreatography was 28.7 ± 16.3 min, and the shortest procedure time in endoscopy was 10.3 ± 3.1 min. The most commonly performed procedure was colonoscopy with 31%. The most commonly used drug combination was midazolam + propofol + fentanyl applied to 1231 patients (48%). 148 (5.76%) patients had minor complication, and 10 (0.37%) patients had major complication. A total of 15 (0.58%) patients underwent intensive care after the procedure. Desaturation was statistically significantly higher in patients with ASA III and above, in procedures take longer than 15 minutes, in patients older than 65 years, and in the presence of chronic obstructive pulmonary disease. The intensive care need after the procedure was also significantly higher in these patient groups.

Conclusion: The incidence of non-operating room anesthesia is increasing steadily. The risks associated with these practices are similar to the anesthesia in the operating room. In order to increase patient safety and reduce complications, it is important to carry out a thorough evaluation before the procedure, to provide proper monitored anesthesia care in appropriate physical conditions, and to establish healthy communication between the teams.